Provider Demographics
NPI:1407161854
Name:ALEXANDER I DEVER III MD PA
Entity Type:Organization
Organization Name:ALEXANDER I DEVER III MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:I
Authorized Official - Last Name:DEVER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:302-421-9330
Mailing Address - Street 1:1500 SHALLCROSS AVE
Mailing Address - Street 2:2ND FLOOR, SUITE A
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-3037
Mailing Address - Country:US
Mailing Address - Phone:302-421-9330
Mailing Address - Fax:302-475-6744
Practice Address - Street 1:1500 SHALLCROSS AVE
Practice Address - Street 2:2ND FLOOR, SUITE A
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-3037
Practice Address - Country:US
Practice Address - Phone:302-421-9330
Practice Address - Fax:302-475-6744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty