Healthcare Provider Details

I. General information

NPI: 1144202466
Provider Name (Legal Business Name): MARCEL VICTOR DIONNE M.D., M.S.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 04/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7999 JEWEL LAKE RD
ANCHORAGE AK
99502-4251
US

IV. Provider business mailing address

9525 KING ST
ANCHORAGE AK
99515-1817
US

V. Phone/Fax

Practice location:
  • Phone: 907-248-8008
  • Fax: 907-644-4477
Mailing address:
  • Phone: 907-346-3247
  • Fax: 907-349-1920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number7736
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number7736
License Number StateAK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: