Provider Demographics
NPI:1801123971
Name:ALEXANDER, VIRGINIA MARY (MD)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:MARY
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:VIRGINIA
Other - Middle Name:MARY
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:701 GROVE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4210
Practice Address - Country:US
Practice Address - Phone:864-455-3287
Practice Address - Fax:864-455-5723
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35956207R00000X, 207RH0002X
SCLL35956207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSC93475019OtherMEDICARE PIN
SC359560Medicaid