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NPI Code Detail

MEDICARE: ALEXANDRA PENDERY MD

MEDICARE: ALEXANDRA PENDERY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician57.253915OH
2207R00000XInternal Medicine PhysicianTP803KY

General Provider Information

NPI Number : 1841907664
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA PENDERY MD
Provider Business Mailing Address
First Line : PO BOX 635283
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-5283
Country : US
Telephone Number : 859-781-2210
Fax Number : 859-781-0289
Provider Business Practice Location Address
First Line : 1400 GRAND AVE
Second Line :
City : NEWPORT
State : KY
Zip : 41071-2570
Country : US
Telephone Number : 859-781-2210
Fax Number : 859-781-0289
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2022
Last Update Date : 03/09/2026

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Directions to “ ALEXANDRA PENDERY MD” Practice Location

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