Provider Demographics
NPI:1245767151
Name:MAZAR, ALEXANDRE JOHN (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRE
Middle Name:JOHN
Last Name:MAZAR
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 1:10000 TELEGRAPH ROAD - BEAUMONT TAYLOR HOSPITAL
Mailing Address - Street 2:PHYSCIAL MEDICINE AND REHABILITATION DEPARTMENT
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180
Mailing Address - Country:US
Mailing Address - Phone:905-441-4557
Mailing Address - Fax:
Practice Address - Street 1:10000 TELEGRAPH ROAD - BEAUMONT TAYLOR HOSPITAL
Practice Address - Street 2:PHYSICAL MEDICINE AND REHABILITATION DEPARTMENT
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180
Practice Address - Country:US
Practice Address - Phone:905-441-4557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program