Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 002137 | CT |
Y | 111NS0005X | Chiropractic Sports Physician | 0104-557583 | VA |
N | 111NS0005X | Chiropractic Sports Physician | CH030207 | DC |
N | 111NS0005X | Chiropractic Sports Physician | S04021 | MD |
NPI | 1114487386 |
---|---|
Provider Name | Dr. Alexander John Elahi |
First Address | Frederick, MD 21701-6815 |
Second Address | Ashburn, VA 20147-5071 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2019 |
Last Update Date | 09/12/2021 |