Provider Demographics
NPI:1861566143
Name:BLEICHER, LAURIE JANE (MD)
Entity type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:JANE
Last Name:BLEICHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 PIPER ST
Mailing Address - Street 2:SUITE U-422
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-6904
Mailing Address - Country:US
Mailing Address - Phone:907-561-2533
Mailing Address - Fax:
Practice Address - Street 1:3851 PIPER ST
Practice Address - Street 2:SUITE U-422
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-6904
Practice Address - Country:US
Practice Address - Phone:907-561-2533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA2038208600000X, 2086S0122X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD2038Medicaid
AK0000BHSWBMedicare ID - Type Unspecified
AKMD2038Medicaid