Healthcare Provider Details
I. General information
NPI: 1417576497
Provider Name (Legal Business Name): ALEXZANDRA DOUGLASS ADLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/10/2020
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
777 BANNOCK ST
DENVER CO
80204-4597
US
IV. Provider business mailing address
PO BOX 110429
AURORA CO
80042-0429
US
V. Phone/Fax
- Phone: 303-436-4949
- Fax: 303-602-9150
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | TL.0008181 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | DR.0072442 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: