Provider Demographics
NPI:1407843808
Name:DALESSANDRO, LOUIS JOHN (DO)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:JOHN
Last Name:DALESSANDRO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2240 REMOUNT RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-4725
Mailing Address - Country:US
Mailing Address - Phone:704-671-5311
Mailing Address - Fax:704-671-5308
Practice Address - Street 1:2711 X RAY DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-7491
Practice Address - Country:US
Practice Address - Phone:704-671-6438
Practice Address - Fax:704-671-6436
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9400037207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC660001575OtherRAILROAD MEDICARE
NC8926769Medicaid
SCN00037Medicaid
SCN00037Medicaid
NC8926769Medicaid