MEDICARE: SANDRA ALEXANDER

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	363A00000X	Physician Assistant	4970	SC

General Provider Information

NPI Number	:	1457741746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA ALEXANDER

Provider Business Mailing Address
First Line	:	1113 44TH AVE N STE 202
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-5781
Country	:	US
Telephone Number	:	843-779-8089
Fax Number	:	854-800-3012

Provider Business Practice Location Address
First Line	:	1113 44TH AVE N STE 202
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-5781
Country	:	US
Telephone Number	:	843-779-8089
Fax Number	:	854-800-3012

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

Provider Enumeration Date	:	01/26/2015
Last Update Date	:	02/09/2026

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Directions to “ SANDRA ALEXANDER ” Practice Location

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