Provider Demographics
NPI:1548603053
Name:ALEXIADES, NIKITA GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:NIKITA
Middle Name:GEORGE
Last Name:ALEXIADES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 S DOBSON RD STE 403
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4777
Mailing Address - Country:US
Mailing Address - Phone:480-412-7473
Mailing Address - Fax:
Practice Address - Street 1:1432 S DOBSON RD STE 403
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4777
Practice Address - Country:US
Practice Address - Phone:480-412-7473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ65270207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery