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NPI Code Detail

MEDICARE: LEON S MENSCH MD

MEDICARE: LEON S MENSCH MD
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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician6964AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11881629616OTHERAKNPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881629616
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEON S MENSCH MD
Provider Business Mailing Address
First Line : PO BOX 1228
Second Line :
City : KASILOF
State : AK
Zip : 99610
Country : US
Telephone Number : 907-345-0004
Fax Number :
Provider Business Practice Location Address
First Line : 250 HOSPITAL PL
Second Line :
City : SOLDOTNA
State : AK
Zip : 99669-6999
Country : US
Telephone Number : 907-714-4502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 03/16/2021

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