Healthcare Provider Details

I. General information

NPI: 1548466014
Provider Name (Legal Business Name): ELIZABETH SUZANNE PIETRALCZYK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 E 42ND AVE
ANCHORAGE AK
99508-5206
US

IV. Provider business mailing address

1120 HUFFMAN RD STE 24-727
ANCHORAGE AK
99515-3516
US

V. Phone/Fax

Practice location:
  • Phone: 999-999-9999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number170865
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: