Provider Demographics
NPI:1679151740
Name:ESPINOZA, ALEJANDRA MICHELLE (DO)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:MICHELLE
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 STAMM DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-0976
Mailing Address - Country:US
Mailing Address - Phone:703-587-2112
Mailing Address - Fax:
Practice Address - Street 1:3800 ROBERT PORCHER WAY STE 200
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2559
Practice Address - Country:US
Practice Address - Phone:336-282-0376
Practice Address - Fax:336-282-0379
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2023-02617207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program