Provider Demographics
NPI:1003859109
Name:MAH, ALEX L (MD)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:L
Last Name:MAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 MOUNT HERMON RD
Mailing Address - Street 2:SUITE 14B
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-5259
Mailing Address - Country:US
Mailing Address - Phone:410-742-4401
Mailing Address - Fax:410-742-4798
Practice Address - Street 1:100 E CARROLL ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5422
Practice Address - Country:US
Practice Address - Phone:410-543-7375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064064207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00397120OtherRAILROAD MEDICARE
MDI54662Medicare UPIN
MDP00397120OtherRAILROAD MEDICARE