Provider Demographics
NPI:1972597888
Name:ALEXANDER, JANETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANETTE
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15005 SHADY GROVE RD
Mailing Address - Street 2:#220
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6340
Mailing Address - Country:US
Mailing Address - Phone:301-251-1184
Mailing Address - Fax:301-251-1185
Practice Address - Street 1:15005 SHADY GROVE RD
Practice Address - Street 2:#220
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6340
Practice Address - Country:US
Practice Address - Phone:301-251-1184
Practice Address - Fax:301-251-1185
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2011-12-05
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
MDD34637208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG36454Medicare UPIN
MD894032Medicare ID - Type Unspecified