Healthcare Provider Details

I. General information

NPI: 1639412695
Provider Name (Legal Business Name): ALEXANDER ARYA EKSIR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 05/28/2022
Certification Date: 05/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5704 MIDDLEBURY PL
GREENSBORO NC
27410-8684
US

IV. Provider business mailing address

5704 MIDDLEBURY PL
GREENSBORO NC
27410-8684
US

V. Phone/Fax

Practice location:
  • Phone: 800-835-2362
  • Fax:
Mailing address:
  • Phone:
  • Fax: 409-777-4763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2015-01558
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: