Provider Demographics
NPI:1174639181
Name:HIRSH, ALEX TODD (MD)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:TODD
Last Name:HIRSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6551 WILSON MILLS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3495
Mailing Address - Country:US
Mailing Address - Phone:440-460-2884
Mailing Address - Fax:440-460-2885
Practice Address - Street 1:6551 WILSON MILLS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-3495
Practice Address - Country:US
Practice Address - Phone:440-460-2884
Practice Address - Fax:440-460-2885
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35080967207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology