Provider Demographics
NPI:1053724757
Name:ANDERSON, ALEC (MD)
Entity type:Individual
Prefix:DR
First Name:ALEC
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:43 WHITING HILL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1006
Mailing Address - Country:US
Mailing Address - Phone:207-973-4670
Mailing Address - Fax:207-973-4669
Practice Address - Street 1:417 STATE STREE
Practice Address - Street 2:WEBBER WEST SUITE 141
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:734-936-9434
Practice Address - Fax:734-232-6020
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEMD22161207V00000X
MI4301105829207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology