Healthcare Provider Details

I. General information

NPI: 1285337469
Provider Name (Legal Business Name): ALEXANDER HARRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1085 N MAIN ST
PROVIDENCE RI
02904-5719
US

IV. Provider business mailing address

195 CANAL ST
MALDEN MA
02148-6701
US

V. Phone/Fax

Practice location:
  • Phone: 401-415-4200
  • Fax:
Mailing address:
  • Phone: 781-338-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD21342
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: