Healthcare Provider Details

I. General information

NPI: 1679154850
Provider Name (Legal Business Name): ALEXANDER CHARTIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E ADAMS ST
SYRACUSE NY
13210-2306
US

IV. Provider business mailing address

14216 W HONEYAGER DR
NEW BERLIN WI
53151-5932
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-1500
  • Fax:
Mailing address:
  • Phone: 414-405-6980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number86908-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: