Provider Demographics
NPI:1821445925
Name:MCCARTY, ALEXANDRA RUHL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:RUHL
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:RUHL
Other - Last Name:MCCARTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NICKNAME
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10350 E DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-1314
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO390200000X
CODR.0061145207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO029138OtherKAISER COMMERCIAL NUMBER
CO9000137369Medicaid