Healthcare Provider Details

I. General information

NPI: 1316019474
Provider Name (Legal Business Name): MICHAEL S REEVES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 UNIVERSITY LAKE DR STE 301
ANCHORAGE AK
99508
US

IV. Provider business mailing address

3801 UNIVERSITY LAKE DR STE 301
ANCHORAGE AK
99508-4658
US

V. Phone/Fax

Practice location:
  • Phone: 907-777-1850
  • Fax: 855-468-1357
Mailing address:
  • Phone: 907-777-1850
  • Fax: 855-468-1357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4371
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: