Provider Demographics
NPI:1639359151
Name:ALEXANDER INTERNAL MEDICINE, PA
Entity Type:Organization
Organization Name:ALEXANDER INTERNAL MEDICINE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-475-9556
Mailing Address - Street 1:1300 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-3419
Mailing Address - Country:US
Mailing Address - Phone:336-475-9556
Mailing Address - Fax:336-475-9672
Practice Address - Street 1:1300 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-3419
Practice Address - Country:US
Practice Address - Phone:336-475-9556
Practice Address - Fax:336-475-9672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31761261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8910633Medicaid
NCC87121Medicare UPIN
NC8910633Medicaid