Provider Demographics
NPI:1366779837
Name:ALEXANDER, MICHAEL ANTHONY (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:ALEXANDER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2255
Mailing Address - Street 2:
Mailing Address - City:KILMARNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22482-2255
Mailing Address - Country:US
Mailing Address - Phone:804-435-8570
Mailing Address - Fax:804-435-8037
Practice Address - Street 1:9175 STAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-2027
Practice Address - Country:US
Practice Address - Phone:804-944-4576
Practice Address - Fax:804-944-4534
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102202758207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV0265AMedicare PIN
VAP00926036Medicare PIN