Healthcare Provider Details

I. General information

NPI: 1669122255
Provider Name (Legal Business Name): ALEXANDER MICHAEL DEAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 DEBARR RD
ANCHORAGE AK
99508-2997
US

IV. Provider business mailing address

PO BOX 771683
EAGLE RIVER AK
99577-1683
US

V. Phone/Fax

Practice location:
  • Phone: 907-276-1131
  • Fax:
Mailing address:
  • Phone: 907-258-9272
  • Fax: 907-258-2405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number249491
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number336357-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: