Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0098-00171 | NC |
N | 2080P0203X | Pediatric Critical Care Doctor | 0098-00171 | NC |
NPI | 1114945987 |
---|---|
Provider Name | Benjamin Stribling Alexander |
First Address | Pinehurst, NC 28374-8710 |
Second Address | Raleigh, NC 27610-1231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 11/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8911553 | (05) | NC |
G69887 | (02) |