Healthcare Provider Details

I. General information

NPI: 1427408947
Provider Name (Legal Business Name): ANA CHARTIER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2016
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3122 E MERIDIAN PARK LOOP STE 2
WASILLA AK
99654-7255
US

IV. Provider business mailing address

3505 E MERIDIAN PARK LOOP STE 100
WASILLA AK
99654-7242
US

V. Phone/Fax

Practice location:
  • Phone: 907-357-3133
  • Fax: 907-357-9522
Mailing address:
  • Phone: 907-357-4963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number163599
License Number StateAK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1714577
Identifier TypeMEDICAID
Identifier StateAK
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: