MEDICARE: DR. ALEXANDER I DEVER III M.D.

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	2084P0800X	Psychiatry Physician	C1-0003123	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C1-0003123	OTHER	DE	M.D. LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568444396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER I DEVER III M.D.

Provider Business Mailing Address
First Line	:	1500 SHALLCROSS AVE
Second Line	:	SUITE A
City	:	WILMINGTON
State	:	DE
Zip	:	19806-3037
Country	:	US
Telephone Number	:	302-421-9330
Fax Number	:	302-475-6744

Provider Business Practice Location Address
First Line	:	1500 SHALLCROSS AVE
Second Line	:	SUITE A
City	:	WILMINGTON
State	:	DE
Zip	:	19806-3037
Country	:	US
Telephone Number	:	302-421-9330
Fax Number	:	302-475-6744

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	03/27/2008

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