Provider Demographics
NPI:1164621884
Name:ALEXANDER, LEQUISHIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LEQUISHIA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 SAINT ANTOINE ST # UHC
Mailing Address - Street 2:WAYNE STATE UNIVERSITY/DMC, DEPT OF INTERNAL MEDICINE
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2153
Mailing Address - Country:US
Mailing Address - Phone:313-745-4832
Mailing Address - Fax:313-745-4052
Practice Address - Street 1:4201 SAINT ANTOINE ST # UHC
Practice Address - Street 2:WAYNE STATE UNIVERSITY/DETROIT MEDICAL CENTER, DEPARTME
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:313-745-4832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301090603207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine