Provider Demographics
NPI:1023032752
Name:ALEXANDER, HENRY RICHARD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:RICHARD
Last Name:ALEXANDER
Suffix:JR
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:PO BOX 64226
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4742
Mailing Address - Country:US
Mailing Address - Phone:410-328-5300
Mailing Address - Fax:410-328-2109
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-5300
Practice Address - Fax:410-328-2109
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAD0044007208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409980000Medicaid
MD256278OtherKAISER
MD88225801OtherBLUE SHIELD
MD2142048OtherMDIPA
MD0113OtherCAREFIRST
MD256278OtherKAISER
MDM60291Medicare UPIN