Provider Demographics
NPI:1235386657
Name:KUEHL, ALEXANDER EDWARD (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:EDWARD
Last Name:KUEHL
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 ROCK ISLAND
Mailing Address - Street 2:
Mailing Address - City:GOUVERNEUR
Mailing Address - State:NY
Mailing Address - Zip Code:13642
Mailing Address - Country:US
Mailing Address - Phone:315-287-2056
Mailing Address - Fax:
Practice Address - Street 1:95 ROCK ISLAND
Practice Address - Street 2:
Practice Address - City:GOUVERNEUR
Practice Address - State:NY
Practice Address - Zip Code:13642
Practice Address - Country:US
Practice Address - Phone:315-287-2056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108749207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY108749Medicaid
NY108749Medicaid