Provider Demographics
NPI:1962443309
Name:PATRICIO, ALEJANDRO M (MD)
Entity type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:M
Last Name:PATRICIO
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:PO BOX 1223
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-1223
Mailing Address - Country:US
Mailing Address - Phone:724-437-0100
Mailing Address - Fax:724-437-8696
Practice Address - Street 1:25 HIGHLAND PARK DR
Practice Address - Street 2:204
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8402
Practice Address - Country:US
Practice Address - Phone:724-437-0100
Practice Address - Fax:724-437-8696
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-034247-L174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered174400000XOther Service ProvidersSpecialist
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007432670002Medicaid
PA0007432670002Medicaid