Provider Demographics
NPI:1336111434
Name:ALEXIOU, JERRI (MD)
Entity Type:Individual
Prefix:
First Name:JERRI
Middle Name:
Last Name:ALEXIOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4549 SPOTSWOOD TRL
Mailing Address - Street 2:STE 8
Mailing Address - City:PENN LAIRD
Mailing Address - State:VA
Mailing Address - Zip Code:22846-2050
Mailing Address - Country:US
Mailing Address - Phone:540-433-8700
Mailing Address - Fax:540-433-8080
Practice Address - Street 1:2062 PRO POINTE LN STE 100
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8021
Practice Address - Country:US
Practice Address - Phone:540-433-8700
Practice Address - Fax:540-433-8080
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231136207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5727789OtherANTHEM BCBS
VA5727789OtherANTHEM BCBS
VAH14808Medicare UPIN