Provider Demographics
NPI:1508209842
Name:HUBBELL, ALEXANDER MATTHEW (MD/MPH)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:MATTHEW
Last Name:HUBBELL
Suffix:
Gender:M
Credentials:MD/MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 24TH AVE S STE 602
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1438
Mailing Address - Country:US
Mailing Address - Phone:612-273-6099
Mailing Address - Fax:
Practice Address - Street 1:606 24TH AVE S STE 602
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1438
Practice Address - Country:US
Practice Address - Phone:612-273-6099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN58587207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty