Healthcare Provider Details

I. General information

NPI: 1457616740
Provider Name (Legal Business Name): ALEXANDER GREGORY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 04/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF ANESTHESIA ROOM C229, FOOTHILLS MEDICAL C 1403- 29 ST NW
CALGARY ALBERTA
T2N 2T9
CA

IV. Provider business mailing address

2411 ERLTON RD SW SUITE 409
CALGARY ALBERTA
T2S 3B9
CA

V. Phone/Fax

Practice location:
  • Phone: 403-944-1430
  • Fax:
Mailing address:
  • Phone: 403-969-6553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number021732
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: