Provider Demographics
NPI:1588699342
Name:PARKER, STEVE EMERY (MD)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:EMERY
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 876196
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-6196
Mailing Address - Country:US
Mailing Address - Phone:907-357-0820
Mailing Address - Fax:907-357-0821
Practice Address - Street 1:17025 SNOWMOBILE LN
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7044
Practice Address - Country:US
Practice Address - Phone:907-694-9553
Practice Address - Fax:907-694-9585
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301083089207Q00000X
AK6631207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD6631Medicaid
11301089OtherCAQH PROVIDER ID
MI4607826Medicaid
MI086910171OtherBCBSM PROVIDER NUMBER
381303843OtherTAX ID
AKMD6631Medicaid
MI086910171OtherBCBSM PROVIDER NUMBER