Provider Demographics
NPI:1215675939
Name:MIKHAIL, ALEXANDRE (MD)
Entity type:Individual
Prefix:MR
First Name:ALEXANDRE
Middle Name:
Last Name:MIKHAIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVENUE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-632-9513
Mailing Address - Fax:617-632-7424
Practice Address - Street 1:330 BROOKLINE AVENUE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-632-9513
Practice Address - Fax:617-632-7424
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2023-03-07
Deactivation Date:2023-02-20
Deactivation Code:
Reactivation Date:2023-03-07
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program