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MAT-SU COMMUNITY PEDIATRICS P.C. NPI 1003142621


NPI Information

NPI: 1003142621
Provider Name: MAT-SU COMMUNITY PEDIATRICS, P.C.
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 02D1039945

Address:
3750 E. COUNTRY FIELD CIRCLE
SUITE C
WASILLA, AK
ZIP 99654
Phone: (907) 357-2955
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MAT-SU COMMUNITY PEDIATRICS, P.C. is a pediatrics in Wasilla, AK. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. MAT-SU COMMUNITY PEDIATRICS, P.C. NPI is 1003142621. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3750 E. COUNTRY FIELD CIRCLE
SUITE C
WASILLA, AK
ZIP 99654
Phone: (907) 357-2955
Fax: (907) 357-9348

The provider's authorized official is Tamara M Krimm .
The authorized official title is President/chief Medical Officer and has the following contact phone number (907) 357-2955.

The CLIA number assigned to this NPI record is 02D1039945 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/2/2009 and was last updated on 11/2/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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