Provider Demographics
NPI:1396745485
Name:ALEXANDER, ANTHONY WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:WAYNE
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:MEDICAL SUITE
Mailing Address - Street 2:600 SENIOR WAY
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6080
Mailing Address - Country:US
Mailing Address - Phone:843-799-1067
Mailing Address - Fax:843-799-0309
Practice Address - Street 1:MEDICAL SUITE
Practice Address - Street 2:600 SENIOR WAY
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6080
Practice Address - Country:US
Practice Address - Phone:843-799-1067
Practice Address - Fax:843-799-0309
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22003207XS0117X, 208100000X
NC200201427208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT59068Medicaid
89063NOOtherN.C. MEDICAID
89063NOOtherN.C. MEDICAID
SCE96750Medicare UPIN