Alcantara, Frederick Manalo

Alcantara, Frederick Manalo is an individual health care provider with primary practice located at 2048 Vip Way , Fairmont WV 26554. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Alcantara, Frederick Manalo can be contacted via phone (304) 366-6200.

Contact Information

Primary practice address
2048 Vip Way Fairmont WV 26554
Phone: (304) 366-6200
Fax: (304) 366-4927
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD432566 Pennsylvania
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 23746 West Virginia

Profile Details

NPI number 1942493812
LBN Legal business name Alcantara, Frederick Manalo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2007
Last updated Apr 6th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942493812 NPPES
Pennsylvania Other AL1983636 BLUE SHIELD
Pennsylvania Other P00434792 BLUE SHIELD
Pennsylvania MEDICAID 1020032650001 BLUE SHIELD

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