Provider Demographics
NPI:1952982555
Name:KNECHT, ALEXANDRIA ISABEL (DO)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:ISABEL
Last Name:KNECHT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9235
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-9235
Mailing Address - Country:US
Mailing Address - Phone:304-293-3092
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-1200
Practice Address - Country:US
Practice Address - Phone:304-293-3092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-16
Last Update Date:2023-07-03
Deactivation Date:2022-06-07
Deactivation Code:
Reactivation Date:2022-07-07
Provider Licenses
StateLicense IDTaxonomies
SCLL87673207R00000X
390200000X
WVED11842085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program