Provider Demographics
NPI:1174584577
Name:ALEXANDER T. MASSENGALE, M.D., P.C.
Entity type:Organization
Organization Name:ALEXANDER T. MASSENGALE, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:MASSENGALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-372-2800
Mailing Address - Street 1:301 S 7TH AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:WEST READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1410
Mailing Address - Country:US
Mailing Address - Phone:610-372-2800
Mailing Address - Fax:610-372-1933
Practice Address - Street 1:301 S 7TH AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1410
Practice Address - Country:US
Practice Address - Phone:610-372-2800
Practice Address - Fax:610-372-1933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-011838-E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B35068Medicare UPIN