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Individual

MARK BRIAN ALEXANDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
101 E WOOD ST STE 401, SPARTANBURG, SC 29303-3040
(864) 560-6654
(864) 560-7353
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
22490
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP5668
SC
01
SCE2815019
MEDICARE PIN
SC
01
SCE2817628
MEDICARE PIN
SC
01
SCE2819068
MEDICARE PIN
SC
Enumeration date
12/28/2018
Last updated
12/07/2020
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