Vanantwerp, Randy L

Vanantwerp, Randy L is an individual health care provider with primary practice located at 2801 Debarr Rd Department Of Pathology, Anchorage AK 99508-2932. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Vanantwerp, Randy L can be contacted via phone (907) 264-1171.

Contact Information

Primary practice address
2801 Debarr Rd Department Of Pathology Anchorage AK 99508-2932
Phone: (907) 264-1171
Fax: (907) 264-1702
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 3473 Alaska

Profile Details

NPI number 1730299660
LBN Legal business name Vanantwerp, Randy L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jul 9th, 2007 - about 17 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 1730299660 NPPES
Alaska MEDICAID MD1801
Alaska MEDICAID GRO825

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