Provider Demographics
NPI:1497490130
Name:DIABETES, OSTEOPOROSIS & WEIGHT LOSS CENTER PLLC
Entity Type:Organization
Organization Name:DIABETES, OSTEOPOROSIS & WEIGHT LOSS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:CONSTANTIN
Authorized Official - Last Name:GELOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-288-4343
Mailing Address - Street 1:2101 CORNWALL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-3676
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2101 CORNWALL AVE STE 101
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3676
Practice Address - Country:US
Practice Address - Phone:360-288-4343
Practice Address - Fax:360-339-5566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-27
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty