Provider Demographics
NPI:1215342779
Name:UKLEJA, ALEXANDRIA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:MARIE
Last Name:UKLEJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:UKLEJA
Other - Last Name:KADOLPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:400 SHELTON ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5655
Mailing Address - Country:US
Mailing Address - Phone:203-809-6446
Mailing Address - Fax:
Practice Address - Street 1:MOSES CONE HOSPITAL
Practice Address - Street 2:1121 N CHURCH ST
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405
Practice Address - Country:US
Practice Address - Phone:336-951-4641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC216979207QA0505X
390200000X
NC2017-01659207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty