Provider Demographics
NPI:1326044173
Name:LAEGER, JANE N (MD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:N
Last Name:LAEGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:700 MOUNT HOPE AVE
Mailing Address - Street 2:STE 430
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5677
Mailing Address - Country:US
Mailing Address - Phone:207-947-8658
Mailing Address - Fax:207-947-4440
Practice Address - Street 1:700 MOUNT HOPE AVE
Practice Address - Street 2:STE 430
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5677
Practice Address - Country:US
Practice Address - Phone:207-947-8658
Practice Address - Fax:207-947-4440
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME011478207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
015400Medicare PIN
B86316Medicare UPIN