Provider Demographics
NPI:1659657948
Name:AKE, STEPHEN D (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:D
Last Name:AKE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 73720
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99707-3720
Mailing Address - Country:US
Mailing Address - Phone:074-593-5119
Mailing Address - Fax:907-459-3588
Practice Address - Street 1:1001 NOBLE ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4948
Practice Address - Country:US
Practice Address - Phone:907-459-3511
Practice Address - Fax:907-459-3588
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9785207Q00000X
AK232717207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1755286Medicaid