Provider Demographics
NPI:1821024779
Name:O'REILLY, MARGRETTA ANN (MD)
Entity Type:Individual
Prefix:
First Name:MARGRETTA
Middle Name:ANN
Last Name:O'REILLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3841 PIPER STREET
Mailing Address - Street 2:SUITE T4-020
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-646-8500
Mailing Address - Fax:907-646-9760
Practice Address - Street 1:3841 PIPER STREET
Practice Address - Street 2:SUITE T4-020
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-646-8500
Practice Address - Fax:907-646-9760
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3222207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD99221Medicaid
AKF64344Medicare UPIN
AKMD99221Medicaid