MEDICARE: DR. FLOYD ELTERMAN 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	207Q00000X	Family Medicine Physician	AA1802	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669461018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FLOYD ELTERMAN MD

Provider Business Mailing Address
First Line	:	1408 19TH AVE
Second Line	:
City	:	FAIRBANKS
State	:	AK
Zip	:	99701-5903
Country	:	US
Telephone Number	:	907-451-6682
Fax Number	:	907-459-3911

Provider Business Practice Location Address
First Line	:	1408 19TH AVE
Second Line	:
City	:	FAIRBANKS
State	:	AK
Zip	:	99701-5903
Country	:	US
Telephone Number	:	907-451-6682
Fax Number	:	907-459-3911

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	07/09/2007

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