Individual
DR. ALEXANDER ALBERT FONDAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
804 S BERKLEY RD, KOKOMO, IN 46901-5198
(765) 457-4455
(765) 457-0056
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(866) 630-9882
(920) 689-4149
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01032543A
IN
Other
Enumeration date
07/22/2006
Last updated
01/22/2015
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