Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARCIANO DAVID BAUTISTA, D.O.
ActiveFamily Medicine · GLENNALLEN, AK
Registration Details
- NPI Number
- 1114078995
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 16, 2007 (19.260137887178 yrs)
- Last Updated
- Mar 31, 2009
- Licenses
-
35579 (CO)4535 (AK)5101013320 (MI)
Practice Information
- Address
-
MILE 187.5 GLENN HWYGLENNALLEN, AK, 995880589Browse AK providers · Browse ZIP 99588
- Phone
- 9078223203
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
- Additional Specialty
- Family Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.