Provider Demographics
NPI:1124554399
Name:EGERTER, ALEXANDER C (DO)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:C
Last Name:EGERTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3 EMBARCADERO CTR LBBY LEVEL
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-4003
Mailing Address - Country:US
Mailing Address - Phone:415-294-1345
Mailing Address - Fax:347-679-6552
Practice Address - Street 1:330 W 58TH ST STE 305
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1801
Practice Address - Country:US
Practice Address - Phone:347-454-6590
Practice Address - Fax:347-679-6552
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.015410207P00000X
NY301583208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine