Healthcare Provider Details

I. General information

NPI: 1801912902
Provider Name (Legal Business Name): MARY P. DEMERS, D.O., & ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 DALE ST STE 201
ANCHORAGE AK
99508-5445
US

IV. Provider business mailing address

4001 DALE ST STE 201
ANCHORAGE AK
99508-5445
US

V. Phone/Fax

Practice location:
  • Phone: 907-263-2201
  • Fax: 907-276-0366
Mailing address:
  • Phone: 907-263-2201
  • Fax: 907-276-0366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number3359
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number3359
License Number StateAK

VIII. Authorized Official

Name: MARY P DEMERS
Title or Position: MANAGER
Credential: D.O.
Phone: 907-263-2200