Healthcare Provider Details

I. General information

NPI: 1982526273
Provider Name (Legal Business Name): ALEXANDER MONSON CHW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 AMERICA AVE NW STE 130
BEMIDJI MN
56601-3848
US

IV. Provider business mailing address

616 AMERICA AVE NW STE 130
BEMIDJI MN
56601-3848
US

V. Phone/Fax

Practice location:
  • Phone: 218-333-8140
  • Fax:
Mailing address:
  • Phone: 218-333-8140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: