Healthcare Provider Details

I. General information

NPI: 1003226846
Provider Name (Legal Business Name): ALEXANDRIA OLIVIA STARKS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 02/15/2021
Certification Date: 02/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 N POINTE BLVD
LANCASTER PA
17601-4132
US

IV. Provider business mailing address

170 N POINTE BLVD
LANCASTER PA
17601-4132
US

V. Phone/Fax

Practice location:
  • Phone: 717-299-4871
  • Fax:
Mailing address:
  • Phone: 717-299-4871
  • Fax: 717-391-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD467974
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: