Individual
ELISHA ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC US NAVY
Contact information
Practice address
1959 MORRIS ST, SUITE 120 BLDG Z101, NORFOLK, VA 23511-3427
(757) 443-0002
(757) 443-5607
Mailing address
1200 RENFREW ST, VIRGINIA BEACH, VA 23464-8915
(757) 467-0561
(757) 443-5706
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/23/2006
Last updated
07/08/2007
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