Provider Demographics
NPI:1346433521
Name:ALEXANDER, ANDREA GARCIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:GARCIA
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:GARCIA
Other - Last Name:WADDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:804 N WILEY AVE
Mailing Address - Street 2:
Mailing Address - City:DONALSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:39845-1120
Mailing Address - Country:US
Mailing Address - Phone:229-524-2808
Mailing Address - Fax:229-524-1272
Practice Address - Street 1:804 N WILEY AVE
Practice Address - Street 2:
Practice Address - City:DONALSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:39845-1120
Practice Address - Country:US
Practice Address - Phone:229-524-2808
Practice Address - Fax:229-524-1272
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060626207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALACSC.41805OtherACSC
1922752427OtherGROUP NPI
ALMD.41805OtherAL LICENSE NUMBER
GA060626OtherGA LICENSE NUMBER
ALMD.41805OtherAL LICENSE NUMBER
GA060626OtherGA LICENSE NUMBER