1770742033 NPI number — DAN G ALEXANDER MD

Table of content: (NPI 1770742033)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770742033 NPI number — DAN G ALEXANDER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAN G ALEXANDER MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1770742033
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1569 SMITH TOWNSHIP STATE ROAD
Provider Second Line Business Mailing Address:
SUITE 6
Provider Business Mailing Address City Name:
ATLASBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-947-5535
Provider Business Mailing Address Fax Number:
724-947-5530

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1569 SMITH TOWNSHIP STATE ROAD
Provider Second Line Business Practice Location Address:
SUITE 6
Provider Business Practice Location Address City Name:
ATLASBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-947-5535
Provider Business Practice Location Address Fax Number:
724-947-5530
Provider Enumeration Date:
06/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ALEXANDER
Authorized Official First Name:
DAN
Authorized Official Middle Name:
G
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
724-947-5535

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD041486E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9689538 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 183553 . This is a "UNISON HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 411189 . This is a "UPMC HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1016420650001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1824674 . This is a "HIGHMARK BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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