Provider Demographics
NPI:1376801274
Name:ALEXANDER, COLLEEN MCINTYRE (MD)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:MCINTYRE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:COLLEEN
Other - Middle Name:MICHELLE
Other - Last Name:MCINTYRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:700 ACKERMAN RD STE 570
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1579
Mailing Address - Country:US
Mailing Address - Phone:614-293-3230
Mailing Address - Fax:614-293-4030
Practice Address - Street 1:1800 ZOLLINGER RD FL 3
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221
Practice Address - Country:US
Practice Address - Phone:614-293-3230
Practice Address - Fax:614-293-4030
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35130060208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0229917Medicaid