MEDICARE: VALLEY SURGICAL ASSOCIATES, INC

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	208600000X	Surgery Physician	1660	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	:	1821047671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY SURGICAL ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	2490 S WOODWORTH LOOP
Second Line	:	SUITE 450
City	:	PALMER
State	:	AK
Zip	:	99645-7405
Country	:	US
Telephone Number	:	907-745-8100
Fax Number	:	907-746-2655

Provider Business Practice Location Address
First Line	:	2490 S WOODWORTH LOOP
Second Line	:	SUITE 450
City	:	PALMER
State	:	AK
Zip	:	99645-7405
Country	:	US
Telephone Number	:	907-745-8100
Fax Number	:	907-746-2655

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL ROSS SENTA
Credential	:	M.D.
Telephone Number	:	907-745-8100

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	12/18/2007

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Directions to “VALLEY SURGICAL ASSOCIATES, INC ” Practice Location

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