Healthcare Provider Details

I. General information

NPI: 1063570232
Provider Name (Legal Business Name): HARLAN RUMJAHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 11/24/2022
Certification Date: 11/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 ZEAMER AVE
ANCHORAGE AK
99506-3702
US

IV. Provider business mailing address

2607 LAUREN CREEK LOOP
ANCHORAGE AK
99507-1485
US

V. Phone/Fax

Practice location:
  • Phone: 907-580-6575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number01055152A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number01055152A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number01055152A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: