Provider Demographics
NPI:1720035991
Name:VERTKIN, ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:VERTKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30117 SCHOENHERR RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6851
Mailing Address - Country:US
Mailing Address - Phone:586-751-8844
Mailing Address - Fax:586-751-8596
Practice Address - Street 1:30117 SCHOENHERR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6851
Practice Address - Country:US
Practice Address - Phone:586-751-8844
Practice Address - Fax:586-751-8596
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301059824207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine