Provider Demographics
NPI:1295333425
Name:HUNTER III, ALEX GEOFFREY
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:GEOFFREY
Last Name:HUNTER III
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 1:1450 GOLDEN GATE BLVD APT D6
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1888
Mailing Address - Country:US
Mailing Address - Phone:216-415-2509
Mailing Address - Fax:
Practice Address - Street 1:1450 GOLDEN GATE BLVD APT D6
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-1888
Practice Address - Country:US
Practice Address - Phone:216-415-2509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide