Dr. Alexander Albert Fondak
Dermatologist
804 S Berkley Rd
Kokomo
, Indiana 46901-5198
Dr. Alexander Albert Fondak
Dermatologist
804 S Berkley Rd
Kokomo
, Indiana 46901-5198
(920) 689-4149
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Dr. Alexander Albert Fondak
- 801 York St
- Manitowoc, WI
- Zip : 54220-4630
- Fax : (920) 689-4149
- Phone : (866) 630-9882
Second Address
- Dr. Alexander Albert Fondak
- 804 S Berkley Rd
- Kokomo, IN
- Zip : 46901-5198
- Fax : (765) 457-0056
- Phone : (765) 457-4455
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | 01032543A | IN |
National Provider Identifier
| NPI | 1033130174 |
|---|---|
| Provider Name | Dr. Alexander Albert Fondak |
| First Address | Manitowoc, WI 54220-4630 |
| Second Address | Kokomo, IN 46901-5198 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/07/2006 |
| Last Update Date | 22/01/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| A61967 | (02) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.