Organization
BLAKE D. ALEXANDER, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE D. ALEXANDER M.D. (OWNER)
(209) 578-5072
Entity
Organization
Contact information
Practice address
1101 STANDIFORD AVE, SUITE A-3, MODESTO, CA 95350-0982
(209) 578-5072
(209) 578-5292
Mailing address
1101 STANDIFORD AVE, SUITE A-3, MODESTO, CA 95350-0982
(209) 578-5072
(209) 578-5292
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
C52849
CA
207ND0101X
MOHS-Micrographic Surgery Physician
C52849
CA
Other
Enumeration date
12/04/2009
Last updated
12/04/2009
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