Provider Demographics
NPI:1295849099
Name:WESTERBAND, ALEX (MD)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:WESTERBAND
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 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:3 RICHLAND MEDICAL PARK DR STE 330
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6862
Practice Address - Country:US
Practice Address - Phone:803-434-7100
Practice Address - Fax:803-434-6889
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC885662086S0129X
AZ231802086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
2Z2585OtherINTERGROUP HEALTHNET
300051634OtherONE HEALTHPLAN
476540101OtherAPIPA
476574OtherINDIAN HEALTH
100099OtherTRAVELERS MC
300051634OtherHUMANA
300051634OtherMARICOPA FOUND
7576061OtherAETNA
AZ300051634OtherHEALTH PLAN AHP
476574OtherAHCCCS
102546OtherRR MC PIN
476574001OtherMERCY CARE
1025422OtherRR MC GRP
102547OtherRR MC PIN
300051634OtherCIGNA
AZ476574Medicaid
AZAZ0763640OtherBCBS
F95880Medicare UPIN
AZAZ0763640OtherBCBS
102547Medicare ID - Type Unspecified