Healthcare Provider Details

I. General information

NPI: 1982693040
Provider Name (Legal Business Name): STEVEN GEORGE ALEXAKOS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 07/10/2020
Certification Date: 07/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 PLEASANT ST MEMORIAL BUILDING, WEST, FLOOR 1
CONCORD NH
03301-2548
US

IV. Provider business mailing address

246 PLEASANT ST MEMORIAL BUILDING, WEST, FLOOR 1
CONCORD NH
03301-2548
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-3388
  • Fax: 603-227-7536
Mailing address:
  • Phone: 603-224-3388
  • Fax: 603-227-7536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number0471
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: