1427150424 NPI number — DR. ANGELICE L. ALEXANDER-MARTIN MD

Table of content: DR. ANGELICE L. ALEXANDER-MARTIN MD (NPI 1427150424)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427150424 NPI number — DR. ANGELICE L. ALEXANDER-MARTIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALEXANDER-MARTIN
Provider First Name:
ANGELICE
Provider Middle Name:
L.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427150424
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2975 DONNYLANE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43235-3228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-442-2600
Provider Business Mailing Address Fax Number:
614-442-1600

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2975 DONNYLANE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43235-3228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-442-2600
Provider Business Practice Location Address Fax Number:
614-442-1600
Provider Enumeration Date:
09/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  35-080261 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0401X , with the licence number: 35080261 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QB0002X , with the licence number: 35080261 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2083A0300X , with the licence number: 35-080261 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 032021509-00 . This is a "BWC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 7355546 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 106506 . This is a "NATIONWIDE HEALTH PLANS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000295047 . This is a "ANTHEM BLUE CROSS BLUE SH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 01-11291 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2364801 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 350809868001 . This is a "MEDICAL MUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".