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NPI Code Detail

MEDICARE: PARTNERS IN HEALTH MEDICAL CLINIC

MEDICARE: PARTNERS IN HEALTH MEDICAL CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician5847AK

General Provider Information

NPI Number : 1427133958
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARTNERS IN HEALTH MEDICAL CLINIC
Provider Business Mailing Address
First Line : 155 E. BLUFF CIRCLE
Second Line :
City : WASILLA
State : AK
Zip : 99654
Country : US
Telephone Number : 907-715-2720
Fax Number :
Provider Business Practice Location Address
First Line : 472 N MAIN ST
Second Line : SUITE B
City : WASILLA
State : AK
Zip : 99654-7018
Country : US
Telephone Number : 907-357-9444
Fax Number :
Authorized Official
Title or Position : PHYSICIAN
Name : RICHARD J ZAJAC
Credential : M.D.
Telephone Number : 907-357-9444
Provider Enumeration Date : 10/25/2006
Last Update Date : 05/23/2008

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Directions to “PARTNERS IN HEALTH MEDICAL CLINIC ” Practice Location

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