Alexander Bassam Anderson, DO
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Augusta, GA
NPI 1124894746 · NPPES record last updated May 14, 2024
Key facts
- NPI
- 1124894746
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- 16261 (GA)
- Practice address
- 1120 15TH St # BF-103B
Augusta, GA 30912-8231 - Phone
- (706) 721-5118
- NPI assigned
- Nov 27, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 16261 | GA | Yes |
Addresses
Primary practice location
1120 15TH St # BF-103B
Augusta, GA 30912-8231
Mailing address
1120 15TH St
Augusta, GA 30912-9533
Other practice location 1
6965 Cumberland Gap Pkwy
Harrogate, TN 37752-8231
Phone (423) 869-7200
Other providers in Augusta, GA
- Megan Anandappa
- John Salvatore Anastasi
- Lakshitha Anbazhakan
- Faye Wright Anders
- Faye S Anderson-Mathis
- Amanda Anderson
- Amy Michelle Anderson
- Baleah Denise Anderson
- Brett Allan Anderson
- Brian Keith Anderson
All providers in Augusta, GA · Anatomic Pathology & Clinical Pathology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.