Healthcare Provider Details

I. General information

NPI: 1932324605
Provider Name (Legal Business Name): PETER D MARBARGER MD APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 DEBARR RD SUITE C 402
ANCHORAGE AK
99508-2953
US

IV. Provider business mailing address

2741 DEBARR RD SUITE C 402
ANCHORAGE AK
99508-2953
US

V. Phone/Fax

Practice location:
  • Phone: 907-561-4363
  • Fax:
Mailing address:
  • Phone: 907-561-4363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberAA1750
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberAA1750
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberAA1750
License Number StateAK

VIII. Authorized Official

Name: DR. PETER D MARBARGER
Title or Position: DOCTOR OF MEDICINE
Credential: M.D.
Phone: 907-561-4363