| Bongo Medical | |
|
3260 Providence Dr #523 Anchorage AK 99508-4608 | |
| (907) 569-1049 | |
| (907) 563-4564 |
| Full Name | Bongo Medical |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 3260 Providence Dr, Anchorage, Alaska |
| Authorized Official Name and Position | Leslie A. Glasgow (CEO) |
| Authorized Official Contact | 9075691049 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bongo Medical 3260 Providence Dr #523 Anchorage AK 99508-4608 Ph: (907) 569-1049 | Bongo Medical 3260 Providence Dr #523 Anchorage AK 99508-4608 Ph: (907) 569-1049 |
| NPI Number | 1619935558 |
|---|---|
| Provider Enumeration Date | 05/02/2006 |
| Last Update Date | 01/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619935558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Secondary |
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