Healthcare Provider Details

I. General information

NPI: 1902434566
Provider Name (Legal Business Name): ALEXANDRIA ALVERDY SPELLMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1085 NE GATEWAY CT NE STE 100
CONCORD NC
28025-2411
US

IV. Provider business mailing address

1085 NE GATEWAY CT NE STE 100
CONCORD NC
28025-2411
US

V. Phone/Fax

Practice location:
  • Phone: 704-707-2200
  • Fax: 704-707-2200
Mailing address:
  • Phone: 704-707-2200
  • Fax: 704-707-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number202604808
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: