Provider Demographics
NPI:1144976606
Name:ALEXOUDIS, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ALEXOUDIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 BLOOMINGTON LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-7155
Mailing Address - Country:US
Mailing Address - Phone:910-619-9911
Mailing Address - Fax:
Practice Address - Street 1:1302 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7503
Practice Address - Country:US
Practice Address - Phone:910-343-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCALEX-WBOG363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner