Healthcare Provider Details

I. General information

NPI: 1346226784
Provider Name (Legal Business Name): ALEX E RIKHTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 12/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3867 ROSWELL RD N.E. SUITE 100
ATLANTA GA
30342-4451
US

IV. Provider business mailing address

1140 HAMMOND DR NE SUITE G7105
ATLANTA GA
30328-5338
US

V. Phone/Fax

Practice location:
  • Phone: 678-904-5611
  • Fax:
Mailing address:
  • Phone: 770-351-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number044070
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: