Individual provider · Type 1 NPI
Alexandre Ivanov
Nutrition Support Pharmacist · Lawrenceville, GA
NPI number
1851269823
Active
Practice location
2512 Young America Dr
Lawrenceville, GA 30043-8002
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nutrition Support Pharmacist Primary | 1835N1003X | RPH029265 (GA) |
Nutrition Support Pharmacist: A licensed pharmacist who has demonstrated specialized knowledge and skill in maintenance and/or restoration of optimal nutritional status, designing and modifying treatment according to patient needs.
About NPI 1851269823
Alexandre Ivanov's National Provider Identifier is 1851269823, issued on Oct 29, 2025. The primary taxonomy on file is Nutrition Support Pharmacist (1835N1003X), and the practice location is in Lawrenceville, GA. The record was last updated on Oct 29, 2025.