Healthcare Provider Details

I. General information

NPI: 1689104499
Provider Name (Legal Business Name): ALEXANDER ELIOT HALSTEAD DNP, CRNP, CRNA, FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF ANESTHESIA, SINAI HOSPITAL OF BALTIMORE 2435 W. BELVEDERE AVE, 5TH FLOOR
BALTIMORE MD
21215
US

IV. Provider business mailing address

2435 W. BELVEDERE AVE, 5TH FLOOR DEPARTMENT OF ANESTHESIA, SINAI HOSPITAL OF BALTIMORE
BALTIMORE MD
21215
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-5209
  • Fax:
Mailing address:
  • Phone: 410-601-5209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR195987
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR195987
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR195987
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: