Individual
DR. ALEXANDER G AVENIROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 STERIGERE ST, NORRISTOWN, PA 19401-5300
(610) 313-5646
(619) 313-1013
Mailing address
1 RIDGE RD, MALVERN, PA 19355-2018
(610) 695-9475
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
MD-035743-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
620068KKB
PIN
PA
01
—
MD-035743-E
MD LICENSE
PA
Enumeration date
11/30/2006
Last updated
03/07/2023
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