Provider Demographics
NPI:1295121432
Name:ALEXA, SHANNON (DO)
Entity type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:
Last Name:ALEXA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 631790
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-1790
Mailing Address - Country:US
Mailing Address - Phone:615-550-4900
Mailing Address - Fax:615-550-4941
Practice Address - Street 1:825 OLD LANCASTER RD STE 170
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3234
Practice Address - Country:US
Practice Address - Phone:610-527-0800
Practice Address - Fax:610-527-9868
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS020812207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology