Provider Demographics
NPI:1104705276
Name:DYE, ALEXANDER GEHRIG (ATP)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:GEHRIG
Last Name:DYE
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 368, 8003 3D RECON BN
Mailing Address - Street 2:
Mailing Address - City:NAGO
Mailing Address - State:OKINAWA
Mailing Address - Zip Code:36180
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BOX 368, 8003 3D RECON BN
Practice Address - Street 2:
Practice Address - City:NAGO
Practice Address - State:OKINAWA
Practice Address - Zip Code:36180
Practice Address - Country:JP
Practice Address - Phone:509-977-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07247491AD1710I1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman