Provider Demographics
NPI:1124003074
Name:HEMINGWAY, ALEXANDER S (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:S
Last Name:HEMINGWAY
Suffix:
Gender:M
Credentials:DC
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 464
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:SC
Mailing Address - Zip Code:29510-0464
Mailing Address - Country:US
Mailing Address - Phone:843-264-8757
Mailing Address - Fax:843-264-8959
Practice Address - Street 1:502 BROOKS RD
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:SC
Practice Address - Zip Code:29510
Practice Address - Country:US
Practice Address - Phone:843-264-8757
Practice Address - Fax:843-264-8959
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH1580Medicaid
SCCH1580Medicaid