Provider Demographics
NPI:1619035516
Name:ALEXANDER, MARCIA (MD)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
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 1566
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:MA
Mailing Address - Zip Code:02653-1566
Mailing Address - Country:US
Mailing Address - Phone:508-255-7283
Mailing Address - Fax:508-255-6013
Practice Address - Street 1:56 LOCUST RD
Practice Address - Street 2:
Practice Address - City:ORLEANS
Practice Address - State:MA
Practice Address - Zip Code:02653
Practice Address - Country:US
Practice Address - Phone:508-255-7283
Practice Address - Fax:508-255-6013
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA540072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ04896Medicare PIN
MAE03307Medicare UPIN