MEDICARE: ALEXANDER KANDABAROW MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	MD030967E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538169560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER KANDABAROW MD

Provider Business Mailing Address
First Line	:	800 PLAZA DR
Second Line	:	SUITE 240
City	:	BELLE VERNON
State	:	PA
Zip	:	15012-4019
Country	:	US
Telephone Number	:	724-379-5816
Fax Number	:	724-379-5874

Provider Business Practice Location Address
First Line	:	800 PLAZA DR
Second Line	:	SUITE 240
City	:	BELLE VERNON
State	:	PA
Zip	:	15012-4019
Country	:	US
Telephone Number	:	724-379-5816
Fax Number	:	724-379-5874

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	09/25/2013

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Directions to “ ALEXANDER KANDABAROW MD” Practice Location

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