Bautista, Marciano David

Bautista, Marciano David is an individual health care provider with primary practice located at Mile 187.5 Glenn Hwy , Glennallen AK 99588-0589. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bautista, Marciano David can be contacted via phone (907) 822-3203.

Contact Information

Primary practice address
Mile 187.5 Glenn Hwy Glennallen AK 99588-0589
Phone: (907) 822-3203
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35579 Colorado
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4535 Alaska
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101013320 Michigan

Profile Details

NPI number 1114078995
LBN Legal business name Bautista, Marciano David
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated Mar 31st, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114078995 NPPES
Alaska Other P00673381 MEDICARE RAILROAD PTAN
Alaska Other 1114078995 MEDICARE RAILROAD PTAN

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