Provider Demographics
NPI:1801355508
Name:DRYMON, ALEXANDRA MICHAELA (DO)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MICHAELA
Last Name:DRYMON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:121 EL PASO RD
Practice Address - Street 2:GENERAL SURGERY - RUIDOSO
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-6033
Practice Address - Country:US
Practice Address - Phone:575-630-8350
Practice Address - Fax:575-257-4055
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMDO2024-0072208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery