Provider Demographics
NPI:1770742033
Name:DAN G ALEXANDER MD
Entity type:Organization
Organization Name:DAN G ALEXANDER MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-947-5535
Mailing Address - Street 1:1569 SMITH TOWNSHIP STATE ROAD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ATLASBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15004
Mailing Address - Country:US
Mailing Address - Phone:724-947-5535
Mailing Address - Fax:724-947-5530
Practice Address - Street 1:1569 SMITH TOWNSHIP STATE ROAD
Practice Address - Street 2:SUITE 6
Practice Address - City:ATLASBURG
Practice Address - State:PA
Practice Address - Zip Code:15004
Practice Address - Country:US
Practice Address - Phone:724-947-5535
Practice Address - Fax:724-947-5530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041486E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA9689538OtherCIGNA HEALTHCARE
PA183553OtherUNISON HEALTH PLAN
PA411189OtherUPMC HEALTH PLAN
PA1016420650001Medicaid
PA1824674OtherHIGHMARK BLUE CROSS BLUE SHIELD
PA411189OtherUPMC HEALTH PLAN
PA9689538OtherCIGNA HEALTHCARE
PA1824674OtherHIGHMARK BLUE CROSS BLUE SHIELD
PA183553OtherUNISON HEALTH PLAN
PA=========OtherUNINTED HEALTHCARE
PA9689538OtherCIGNA HEALTHCARE