Individual
MR. JOHN ALEXANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6 BRIDAL PATH CT, COLUMBIA, SC 29229-9316
(864) 616-2108
(803) 865-1792
Mailing address
6 BRIDAL PATH CT, COLUMBIA, SC 29229-9316
(864) 616-2108
(803) 865-1792
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2007-30991-30138
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30991
RICHLANDCNTYBUSINESSNUMB
SC
Enumeration date
06/22/2007
Last updated
07/08/2007
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