Healthcare Provider Details

I. General information

NPI: 1790837367
Provider Name (Legal Business Name): ALEXANDER CORACIDES NMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9188 E SAN SALVADOR DR SUITE 201
SCOTTSDALE AZ
85258-5562
US

IV. Provider business mailing address

9188 E SAN SALVADOR DR SUITE 201
SCOTTSDALE AZ
85258-5562
US

V. Phone/Fax

Practice location:
  • Phone: 480-292-8877
  • Fax: 480-292-8868
Mailing address:
  • Phone: 480-292-8877
  • Fax: 480-292-8868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number03720
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: