Healthcare Provider Details

I. General information

NPI: 1831148097
Provider Name (Legal Business Name): DANNY ROGER FIJALKOWSKI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 10/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51339 NATIONAL RD E
SAINT CLAIRSVILLE OH
43950-9119
US

IV. Provider business mailing address

51339 NATIONAL RD E
SAINT CLAIRSVILLE OH
43950-9119
US

V. Phone/Fax

Practice location:
  • Phone: 740-695-1210
  • Fax: 740-695-4304
Mailing address:
  • Phone: 740-695-1210
  • Fax: 740-695-4304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC005912
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: