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General NPI Number Information
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NPI Number | 1245397090
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Entity Type | Individual
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Provider Name | CHARLES ALEXANDER M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 107 JOHN ST STE 3A
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City | SOUTHPORT
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State | CT
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Zip | 06890-1466
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Country | US
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Telephone | 203-259-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 321 GULF ST
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City | MILFORD
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State | CT
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Zip | 06460-6533
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Country | US
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Telephone | 203-981-5877
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 037432
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License Number State | CT
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