Individual
ALEXANDRA SLEDD MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
825 FAIRFAX AVE, STE 118, NORFOLK, VA 23507-1914
(757) 446-5955
(757) 446-5196
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-5955
(757) 446-5196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101260428
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174812192
CIGNA
VA
05
—
1174812192
—
NC
05
—
1174812192
—
VA
Enumeration date
03/30/2011
Last updated
02/06/2024
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