Provider Demographics
NPI:1518910694
Name:ALEXANDER, ALBERT I IV (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:I
Last Name:ALEXANDER
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10417
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01041-2017
Mailing Address - Country:US
Mailing Address - Phone:413-540-0150
Mailing Address - Fax:413-540-0159
Practice Address - Street 1:2 MEDICAL CENTER DR
Practice Address - Street 2:SUITE # 404
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1270
Practice Address - Country:US
Practice Address - Phone:413-736-3163
Practice Address - Fax:413-733-0206
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA59329208600000X
CT029819208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3046036Medicaid
484240OtherCCARE
1704892OtherUNITED HEALTH CARE
801579OtherHAVARD PILGRAM HEALTH CAR
MAJ08141OtherBLUE CROSS BLUE SHIELD
9186280-003OtherCIGNA
10118OtherHEALTH NEW ENGLAND
717899OtherTUFTS
92924OtherAETNA
92924OtherAETNA
MAJ08141OtherBLUE CROSS BLUE SHIELD