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General NPI Number Information
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NPI Number | 1962953539
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Entity Type | Individual
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Provider Name | ALEXANDER KUDINOV
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Gender | Male
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Dates
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Enumeration Date | 10/19/2016
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 1223 S GEAR AVE STE 109
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City | WEST BURLINGTON
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State | IA
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Zip | 52655-1685
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Country | US
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Telephone | 319-768-1820
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Fax |
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Provider Business Mailing Address
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Address Line | 1 UNIVERSITY OF NEW MEXICO
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-0001
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Country | US
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Telephone | 505-272-4865
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD-51543
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License Number State | IA
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