Individual
ALEXANDRE ANDRE DEBETENCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1000 BESTGATE RD STE 400, ANNAPOLIS, MD 21401-3371
(410) 266-2720
(410) 224-0209
Mailing address
1000 BESTGATE RD STE 400, ANNAPOLIS, MD 21401-3371
(410) 266-2720
(410) 224-0209
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C06988
MD
363AS0400X
Surgical Physician Assistant
C06988
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140207200
—
MD
Enumeration date
10/12/2018
Last updated
11/26/2018
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