Basic Information
| Provider Information | |||||||||
| NPI: | 1295849099 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WESTERBAND | ||||||||
| FirstName: | ALEX | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 E MCBEE AVE FL 4 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296012842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645228603 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3 RICHLAND MEDICAL PARK DR STE 330 | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292036862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8034347100 | ||||||||
| FaxNumber: | 8034346889 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2006 | ||||||||
| LastUpdateDate: | 09/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | 88566 | SC | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 2086S0129X | 23180 | AZ | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 2Z2585 | 01 | INTERGROUP HEALTHNET | OTHER | 300051634 | 01 | ONE HEALTHPLAN | OTHER | 476540101 | 01 | APIPA | OTHER | 476574 | 01 | INDIAN HEALTH | OTHER | 100099 | 01 | TRAVELERS MC | OTHER | 300051634 | 01 | HUMANA | OTHER | 300051634 | 01 | MARICOPA FOUND | OTHER | 7576061 | 01 | AETNA | OTHER | 300051634 | 01 | AZ | HEALTH PLAN AHP | OTHER | 476574 | 01 | AHCCCS | OTHER | 102546 | 01 | RR MC PIN | OTHER | 476574001 | 01 | MERCY CARE | OTHER | 1025422 | 01 | RR MC GRP | OTHER | 102547 | 01 | RR MC PIN | OTHER | 300051634 | 01 | CIGNA | OTHER | 476574 | 05 | AZ | MEDICAID | AZ0763640 | 01 | AZ | BCBS | OTHER |