Provider Demographics
NPI:1619165412
Name:WEST, ALEX (DPM)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:WEST
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48240 MANORWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-8480
Mailing Address - Country:US
Mailing Address - Phone:248-787-2233
Mailing Address - Fax:
Practice Address - Street 1:48240 MANORWOOD DR
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48168-8480
Practice Address - Country:US
Practice Address - Phone:248-787-2233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001051213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery