Provider Demographics
NPI:1265876932
Name:OVERMILLER, ALEX CARL (MD)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:CARL
Last Name:OVERMILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 HURST DR
Mailing Address - Street 2:
Mailing Address - City:POPE FIELD
Mailing Address - State:NC
Mailing Address - Zip Code:28308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1520 HURST DR
Practice Address - Street 2:
Practice Address - City:POPE FIELD
Practice Address - State:NC
Practice Address - Zip Code:28308
Practice Address - Country:US
Practice Address - Phone:316-394-3261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT203333208600000X, 390200000X
NC2021-02298207P00000X
WV26161207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program