MARCIANO DAVID BAUTISTA D.O. NPI 1114078995

NPI Information

  • NPI: 1114078995
  • Provider Name: MARCIANO DAVID BAUTISTA, D.O.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • Address: MILE 187.5 GLENN HWY
    GLENNALLEN, AK
    ZIP 99588
  • Phone: (907) 822-3203

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NPI Details

Marciano David Bautista, D.O. is a family medicine in Glennallen, AK. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Marciano David Bautista, D.O. NPI is 1114078995. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

MILE 187.5 GLENN HWY
GLENNALLEN, AK
ZIP 99588-589
Phone: (907) 822-3203

The enumeration date for this NPI number is 1/16/2007 and was last updated on 3/31/2009.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine35579COLORADONo
2207Q00000XFamily Medicine5101013320MICHIGANNo
3207Q00000XFamily Medicine4535ALASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1K162088MEDICARE PINALASKA
2P00673381OTHERALASKAMEDICARE RAILROAD PTAN
3G03796MEDICARE UPIN
41114078995OTHERALASKANPI

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: 11/21/2025

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