Provider Demographics
NPI:1225410772
Name:ALEXANDER, DAVID I
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:I
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CLARKE PL
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-6529
Mailing Address - Country:US
Mailing Address - Phone:301-360-1460
Mailing Address - Fax:301-360-1403
Practice Address - Street 1:101 CLARKE PL
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6529
Practice Address - Country:US
Practice Address - Phone:301-360-1460
Practice Address - Fax:301-360-1403
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01373231H00000X
KYSLPAUD00219027231H00000X
OHA.01971231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA.01971OtherOHIO AUDIOLOGY LICENSE
MD01373OtherMARYLAND BOARD OF AUDIOLOGISTS, HEARING AID DISPENSERS & SPEECH-LANGUAGE PATHOLO
KYSLPAUD00219027OtherKENTUCKY AUDIOLOGY LICENSE