Individual
OMAR BOSTON ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 GROVE RD FL 5, GREENVILLE, SC 29605-4210
(864) 455-4411
(864) 455-4480
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL31132
SC
208M00000X
Hospitalist Physician
Primary
31132
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311326
—
SC
05
—
GP5407
—
SC
Enumeration date
06/27/2008
Last updated
07/19/2021
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