MEDICARE: ALEXANDRA VALENTINE EICK PA-C

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	5601014050	MI

General Provider Information

NPI Number	:	1952233843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA VALENTINE EICK PA-C

Provider Business Mailing Address
First Line	:	559 GREENWOOD ST
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-1341
Country	:	US
Telephone Number	:	248-885-6867
Fax Number	:

Provider Business Practice Location Address
First Line	:	559 GREENWOOD ST
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-1341
Country	:	US
Telephone Number	:	248-885-6867
Fax Number	:

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

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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