Individual
JARED A FIALKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 HOSPITAL LN, SUITE 145, DANVILLE, IN 46122-1989
(317) 718-2460
(317) 718-2465
Mailing address
1100 SOUTHFIELD DR, SUITE 1370, PLAINFIELD, IN 46168-4498
(317) 837-5571
(317) 837-5580
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02003054A
IN
207RN0300X
Nephrology Physician
Primary
02003054
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200817050
—
IN
Enumeration date
04/13/2006
Last updated
03/04/2021
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