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NPI Code Detail

MEDICARE: DR. ALEXANDRA NEWLIN POWELL M.D.

MEDICARE: DR. ALEXANDRA NEWLIN POWELL 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
12084P0015XPsychosomatic Medicine Physician99-01594NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1131FJOTHERNCBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1932311339
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXANDRA NEWLIN POWELL M.D.
Provider Business Mailing Address
First Line : 2020 W MAIN ST
Second Line : SUITE #20
City : DURHAM
State : NC
Zip : 27705-4683
Country : US
Telephone Number : 919-286-9100
Fax Number :
Provider Business Practice Location Address
First Line : 2020 W MAIN ST
Second Line : SUITE #20
City : DURHAM
State : NC
Zip : 27705-4683
Country : US
Telephone Number : 919-286-9100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2007
Last Update Date : 07/08/2007

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