Healthcare Provider Details

I. General information

NPI: 1982099792
Provider Name (Legal Business Name): ALEXANDRA E CHAROS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 12/26/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PILLSBURY ST STE 501
CONCORD NH
03301-3576
US

IV. Provider business mailing address

2 PILLSBURY ST STE 501
CONCORD NH
03301-3576
US

V. Phone/Fax

Practice location:
  • Phone: 603-626-7546
  • Fax: 603-715-8987
Mailing address:
  • Phone: 603-626-7546
  • Fax: 603-715-8987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number21427
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: