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NPI Verification

National Provider Identifier: 1114078995

Marciano David Bautista, D.o.

Individual Provider

Credentials

D.O.

Primary Specialty

Family Medicine

Code: 207Q00000X

All Specialties (3)

Family Medicine

Code: 207Q00000X

Family Medicine

Code: 207Q00000X

Primary

Family Medicine

Code: 207Q00000X

Practice Address

MILE 187.5 GLENN HWY

GLENNALLEN, AK 995880589

Phone: 907-822-3203

NPI Enumeration Date

January 16, 2007

NPI Number

1114078995

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry