Provider Demographics
NPI:1043673270
Name:GOLEC, ALEXANDER S (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:S
Last Name:GOLEC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:200 N WOLFE ST RM 2063
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0011
Mailing Address - Country:US
Mailing Address - Phone:410-955-2910
Mailing Address - Fax:410-502-5440
Practice Address - Street 1:200 N WOLFE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0011
Practice Address - Country:US
Practice Address - Phone:410-955-2910
Practice Address - Fax:410-502-5440
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0099006208000000X, 2083A0300X, 2080A0000X
OH35.1428902080A0000X, 2084A0401X
MDD990062251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics