Healthcare Provider Details

I. General information

NPI: 1922003334
Provider Name (Legal Business Name): HOLLY L. ALEXANDRE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 STATE ROAD PEQUOT BLDG
NORTH DARTMOUTH MA
02747
US

IV. Provider business mailing address

200 MILL RD SUITE 180
FAIRHAVEN MA
02719-5252
US

V. Phone/Fax

Practice location:
  • Phone: 508-973-2206
  • Fax: 508-973-9275
Mailing address:
  • Phone: 508-973-2000
  • Fax: 508-973-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number220744
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: