Healthcare Provider Details

I. General information

NPI: 1083458525
Provider Name (Legal Business Name): ALEX LERE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL PARK
WHEELING WV
26003-6300
US

IV. Provider business mailing address

PO BOX 644118
PITTSBURGH PA
15264-4118
US

V. Phone/Fax

Practice location:
  • Phone: 304-243-3000
  • Fax: 304-243-3060
Mailing address:
  • Phone: 304-243-3070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3153
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA065559
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: