Provider Demographics
NPI:1184319337
Name:HUBRECHT, ALEXANDER CHARLES
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:CHARLES
Last Name:HUBRECHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 HOWE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-2303
Mailing Address - Country:US
Mailing Address - Phone:317-730-5014
Mailing Address - Fax:
Practice Address - Street 1:6900 FOREST AVE STE 110
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1730
Practice Address - Country:US
Practice Address - Phone:804-893-8715
Practice Address - Fax:804-285-1292
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty