Provider Demographics
NPI:1801912902
Name:MARY P. DEMERS, D.O., & ASSOCIATES, LLC
Entity type:Organization
Organization Name:MARY P. DEMERS, D.O., & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:P
Authorized Official - Last Name:DEMERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:907-263-2200
Mailing Address - Street 1:4001 DALE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5445
Mailing Address - Country:US
Mailing Address - Phone:907-263-2201
Mailing Address - Fax:907-276-0366
Practice Address - Street 1:4001 DALE ST STE 201
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5445
Practice Address - Country:US
Practice Address - Phone:907-263-2201
Practice Address - Fax:907-276-0366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK33592083X0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK161076Medicare PIN