Grendahl, Marvin
Grendahl, Marvin is an sole proprietor health care provider with primary practice located at 3500 Latouche St Suite 230, Anchorage AK 99508-4209. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Grendahl, Marvin can be contacted via phone (907) 561-1917.Contact Information
Primary practice address
3500 Latouche St Suite 230
Anchorage AK 99508-4209
Phone: (907) 561-1917
Fax: (907) 563-5373
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD1417 | Alaska |
Profile Details
| NPI number | 1871695791 |
|---|---|
| LBN Legal business name | Grendahl, Marvin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 1st, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871695791 | NPPES |
| Alaska | MEDICAID | MD1417 |
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