| Doctor Name: | DR. ALEXANDRA MARIA ELIZABETH IDENBURG |
| NPI Number: | 1992133102 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD, MRCGP(UK) |
| License Number: | MD19326 |
| Business Practice Address: | 447 N Main St Pittsfield, ME - 049673707 |
| Business Phone Number: | 2074874000 |
| Business Fax Number: | 2074873790 |
| Mailing Address: | 447 N Main St, PITTSFIELD |
| State: | ME |
| Postal Code: | 049673707 |
| Phone Number: | 2074874000 |
| Fax Number: | 2074873790 |
| NPI Enumeration Date: | 10/25/2013 |
| NPI Last Update Date: | 10/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD19326 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |