Provider Demographics
NPI:1194700690
Name:ALEXANDER, MARSHA GAUNT (MD)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:GAUNT
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:PHYSICIAN SERVICES; S6
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-347-5320
Mailing Address - Fax:612-373-1886
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:DEPT OF OB/GYN; P5
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-2750
Practice Address - Fax:612-904-4274
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN25271207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN637702500Medicaid
MN637702500Medicaid
A94696Medicare UPIN