Provider Demographics
NPI:1316097223
Name:ALEXANDER, MARK PETER (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:PETER
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:DR
Other - First Name:EMAD
Other - Middle Name:CHAFFIC
Other - Last Name:CHAROAPEAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5301 WELLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:VENTNOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08406-1449
Mailing Address - Country:US
Mailing Address - Phone:609-823-0555
Mailing Address - Fax:609-823-0330
Practice Address - Street 1:5301 WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:VENTNOR CITY
Practice Address - State:NJ
Practice Address - Zip Code:08406-1449
Practice Address - Country:US
Practice Address - Phone:609-823-0555
Practice Address - Fax:609-823-0330
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-26767207R00000X
MO112522207R00000X
NJ25MA08323800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine