MEDICARE: DR. MARCEL VICTOR DIONNE M.D., M.S.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician	7736	AK
2	2083A0100X	Aerospace Medicine Physician	7736	AK

General Provider Information

NPI Number	:	1144202466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCEL VICTOR DIONNE M.D., M.S.P.H.

Provider Business Mailing Address
First Line	:	9525 KING ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99515-1817
Country	:	US
Telephone Number	:	907-346-3247
Fax Number	:	907-349-1920

Provider Business Practice Location Address
First Line	:	7999 JEWEL LAKE RD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99502-4251
Country	:	US
Telephone Number	:	907-248-8008
Fax Number	:	907-644-4477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	04/28/2014

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