Healthcare Provider Details
I. General information
NPI: 1730640780
Provider Name (Legal Business Name): ALEXANDER ANDREW VALIGA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/30/2019
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
537 STANTON CHRISTIANA RD
NEWARK DE
19713-2146
US
IV. Provider business mailing address
537 STANTON CHRISTIANA RD
NEWARK DE
19713-2146
US
V. Phone/Fax
- Phone: 302-633-7550
- Fax:
- Phone: 302-633-7550
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207NS0135X |
| Taxonomy | Procedural Dermatology Physician |
| License Number | C1-0027055 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ND0101X |
| Taxonomy | MOHS-Micrographic Surgery Physician |
| License Number | C1-0027055 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: