MEDICARE: DR. ANDREW G ALEXANDER 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	G50850	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710963400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW G ALEXANDER MD

Provider Business Mailing Address
First Line	:	913 WASHINGTON ST
Second Line	:
City	:	CALISTOGA
State	:	CA
Zip	:	94515-1433
Country	:	US
Telephone Number	:	707-942-6233
Fax Number	:	707-942-6382

Provider Business Practice Location Address
First Line	:	913 WASHINGTON ST
Second Line	:
City	:	CALISTOGA
State	:	CA
Zip	:	94515-1433
Country	:	US
Telephone Number	:	707-942-6233
Fax Number	:	707-942-6382

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	11/21/2007

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