| Wasilla Internal Medicine Llc | |
|
3719 E Meridian Loop Ste F Wasilla AK 99654-7273 | |
| (907) 373-5940 | |
| (907) 373-5947 |
| Full Name | Wasilla Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3719 E Meridian Loop Ste F, Wasilla, Alaska |
| Authorized Official Name and Position | Mettessa Maye Reid (ADMINISTRATOR) |
| Authorized Official Contact | 9072503482 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wasilla Internal Medicine Llc 3719 E Meridian Loop Ste F Wasilla AK 99654-7273 Ph: (907) 373-5940 | Wasilla Internal Medicine Llc 3719 E Meridian Loop Ste F Wasilla AK 99654-7273 Ph: (907) 373-5940 |
| NPI Number | 1578110011 |
|---|---|
| Provider Enumeration Date | 08/20/2019 |
| Last Update Date | 08/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578110011 | NPI | - | NPPES |
| MD5445 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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