Basic Information
| Provider Information | |||||||||
| NPI: | 1811251762 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DRETLER | ||||||||
| FirstName: | ALEXANDRA | ||||||||
| MiddleName: | WOLCOTT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2665 N DECATUR RD | ||||||||
| Address2: | STE 330 | ||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300336145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042979755 | ||||||||
| FaxNumber: | 4042975008 | ||||||||
| Practice Location | |||||||||
| Address1: | 4901 FOREST PARK AVE | ||||||||
| Address2: | STE 2 | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631081402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3143625060 | ||||||||
| FaxNumber: | 3143626959 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2012 | ||||||||
| LastUpdateDate: | 07/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 83122 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 208M00000X | 2015008497 | MO | N | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.