MEDICARE: MR. ALEXANDER OSCAR TEJEDA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MT229275	PA

General Provider Information

NPI Number	:	1386347359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALEXANDER OSCAR TEJEDA MD

Provider Business Mailing Address
First Line	:	401 W ALLEGHENY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19133-3647
Country	:	US
Telephone Number	:	215-291-2500
Fax Number	:	215-291-2587

Provider Business Practice Location Address
First Line	:	401 W ALLEGHENY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19133-3647
Country	:	US
Telephone Number	:	215-291-2500
Fax Number	:	215-291-2587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2023
Last Update Date	:	05/13/2026

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