Provider Demographics
NPI:1073590014
Name:ALEXANDER, ERIK EDWIN (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:EDWIN
Last Name:ALEXANDER
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 1:10301 N 92ND ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4511
Mailing Address - Country:US
Mailing Address - Phone:480-661-2662
Mailing Address - Fax:480-661-9716
Practice Address - Street 1:10301 N 92ND ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4511
Practice Address - Country:US
Practice Address - Phone:480-661-2662
Practice Address - Fax:480-661-9716
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27324208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ592750Medicaid
F88688Medicare UPIN
AZ101497Medicare ID - Type Unspecified