Provider Demographics
NPI:1699841346
Name:MAIR, ALFRED SR (MD)
Entity Type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:
Last Name:MAIR
Suffix:SR
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:PO BOX 3942
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-3942
Mailing Address - Country:US
Mailing Address - Phone:787-882-4444
Mailing Address - Fax:
Practice Address - Street 1:AVE GEVERIANOCUEVAS 24 AGUADILLA MEDICAL PLAZA
Practice Address - Street 2:SUITE #206
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-882-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4953207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
C79533Medicare UPIN