Provider Demographics
NPI:1629228689
Name:POOR, ALEXANDER EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:EDWARD
Last Name:POOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 CONSTITUTION AVE
Mailing Address - Street 2:VINCERA INSTITUTE
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19112-1329
Mailing Address - Country:US
Mailing Address - Phone:215-840-0537
Mailing Address - Fax:888-393-3980
Practice Address - Street 1:1200 CONSTITUTION AVE
Practice Address - Street 2:VINCERA INSTITUTE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19112-1329
Practice Address - Country:US
Practice Address - Phone:215-840-0537
Practice Address - Fax:888-393-3980
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD437907208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery