Provider Demographics
NPI:1063098473
Name:DRESDEN, ALEXANDER YOUNG-OO (DO)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:YOUNG-OO
Last Name:DRESDEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5502 SEDGEMEADOW RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-1249
Mailing Address - Country:US
Mailing Address - Phone:843-597-2723
Mailing Address - Fax:
Practice Address - Street 1:752 N HIGH POINT RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-2236
Practice Address - Country:US
Practice Address - Phone:608-824-0000
Practice Address - Fax:608-824-4917
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-12046207Q00000X
WI81393207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1063098473Medicaid