Provider Demographics
NPI:1992743819
Name:GITERMAN, ALEKSANDR M (DC)
Entity type:Individual
Prefix:DR
First Name:ALEKSANDR
Middle Name:M
Last Name:GITERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8040 OLD CEDAR S AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1234
Mailing Address - Country:US
Mailing Address - Phone:651-789-8022
Mailing Address - Fax:651-789-8028
Practice Address - Street 1:8040 OLD CEDAR S AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1234
Practice Address - Country:US
Practice Address - Phone:651-789-8022
Practice Address - Fax:651-789-8028
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4820OtherLICENSE