Individual
MR. ALEXANDER C FANAROFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.H.S.
Contact information
Practice address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
(215) 662-4000
Mailing address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
173555
NC
207RC0000X
Cardiovascular Disease Physician
Primary
MD468186
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2011
Last updated
08/13/2019
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