MEDICARE: DR. DEBBIE A DRAGICH MD

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	207L00000X	Anesthesiology Physician	29783	AZ

General Provider Information

NPI Number	:	1588640122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBBIE A DRAGICH MD

Provider Business Mailing Address
First Line	:	11019 BARONIK ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99516
Country	:	US
Telephone Number	:	907-346-4113
Fax Number	:

Provider Business Practice Location Address
First Line	:	11019 BARONIK ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99516
Country	:	US
Telephone Number	:	907-346-4113
Fax Number	:

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	07/08/2007

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