Provider Demographics
NPI:1134138175
Name:MIH, ALEXANDER DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:DAVID
Last Name:MIH
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 1:629 S PLUMMER AVE
Mailing Address - Street 2:P.O. BOX 426
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-1928
Mailing Address - Country:US
Mailing Address - Phone:620-431-4000
Mailing Address - Fax:620-431-7556
Practice Address - Street 1:1500 W 7TH ST
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-2575
Practice Address - Country:US
Practice Address - Phone:620-432-5775
Practice Address - Fax:620-431-1106
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-38560207X00000X
IN01037452A207XS0106X
IN010374522086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS04-38560OtherSTATE LICENSE
000000083018OtherANTHEM HEALTH PLAN
3192469001OtherCIGNA
IN100347890Medicaid
IN020014653Medicare PIN
IN062110YMedicare PIN
KS04-38560OtherSTATE LICENSE
IN100347890Medicaid
3192469001OtherCIGNA