| Doctor Name: | MARK ANDREW MALZAHN |
| NPI Number: | 1003917386 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A.-C. |
| License Number: | 453 |
| Business Practice Address: | 4100 Lake Otis Pkwy #302 Anchorage, AK - 995085222 |
| Business Phone Number: | 9075637072 |
| Business Fax Number: | 9075625742 |
| Mailing Address: | 4100 Lake Otis Pkwy, #302 ANCHORAGE |
| State: | AK |
| Postal Code: | 995085222 |
| Phone Number: | 9075637072 |
| Fax Number: | 9075625742 |
| NPI Enumeration Date: | 09/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 453 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |