Healthcare Provider Details

I. General information

NPI: 1417658311
Provider Name (Legal Business Name): ALEXANDRIA DANYLUK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 FOSTER ST
DURHAM NC
27701-2107
US

IV. Provider business mailing address

530 FOSTER ST
DURHAM NC
27701-2107
US

V. Phone/Fax

Practice location:
  • Phone: 954-646-5940
  • Fax:
Mailing address:
  • Phone: 954-646-5940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberRTL24-0359
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: