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Contact Information

DERRICK A MANZLAK, MD
3976 UNIVERSITY LAKE DR STE 100
ANCHORAGE, AK99508-4644
 Phone: 907-729-8141
 Fax: 907-729-3998
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sleep Medicine

2084S0012X 86 Physician/Neuropsychiatry
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for DERRICK A MANZLAK · (Male)

NPI Number 1235429457
Status Active
Credentials MD
Entity Individual
Enumeration date 04/08/2011
Last updated 10/13/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 261728
  • VA License # 0101262628
  • VA Medicaid 1235429457
Hospital affiliation(s)
  • ALASKA NATIVE MEDICAL CENTER - (Acute Care)
    4315 DIPLOMACY DR
    ANCHORAGE, AK 99508
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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