MEDICARE: STEVEN GEORGE ALEXAKOS 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	363AS0400X	Surgical Physician Assistant	0471	NH

General Provider Information

NPI Number	:	1982693040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN GEORGE ALEXAKOS PA-C

Provider Business Mailing Address
First Line	:	246 PLEASANT ST
Second Line	:	MEMORIAL BUILDING, WEST, FLOOR 1
City	:	CONCORD
State	:	NH
Zip	:	03301-2548
Country	:	US
Telephone Number	:	603-224-3388
Fax Number	:	603-227-7536

Provider Business Practice Location Address
First Line	:	246 PLEASANT ST
Second Line	:	MEMORIAL BUILDING, WEST, FLOOR 1
City	:	CONCORD
State	:	NH
Zip	:	03301-2548
Country	:	US
Telephone Number	:	603-224-3388
Fax Number	:	603-227-7536

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	07/10/2020

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