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General NPI Number Information
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NPI Number | 1558419093
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Entity Type | Individual
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Provider Name | JANE ANN S. DIMER M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 1650 COWLES ST
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City | FAIRBANKS
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State | AK
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Zip | 99701-5907
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Country | US
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Telephone | 907-458-2794
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 COWLES ST
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City | FAIRBANKS
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State | AK
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Zip | 99701-5907
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Country | US
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Telephone | 907-458-2794
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD00036721
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 231304
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License Number State | AK
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