MEDICARE: ALEX MICHAEL MA 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	26402	NV

General Provider Information

NPI Number	:	1972180404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX MICHAEL MA MD

Provider Business Mailing Address
First Line	:	6655 S CIMARRON RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2181
Country	:	US
Telephone Number	:	702-853-3561
Fax Number	:

Provider Business Practice Location Address
First Line	:	4469 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1605
Country	:	US
Telephone Number	:	702-637-2114
Fax Number	:	888-481-1462

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

Provider Enumeration Date	:	03/29/2021
Last Update Date	:	03/10/2025

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