Antalis, Alexander D
Antalis, Alexander D is an individual health care provider with primary practice located at 2200 Randallia Dr , Fort Wayne IN 46805-4638. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Antalis, Alexander D can be contacted via phone (260) 373-4000.Contact Information
Primary practice address
2200 Randallia Dr
Fort Wayne IN 46805-4638
Phone: (260) 373-4000
Fax: (260) 482-4442
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 01032122A | Indiana |
Profile Details
| NPI number | 1891780292 |
|---|---|
| LBN Legal business name | Antalis, Alexander D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2005 |
| Last updated | Apr 5th, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891780292 | NPPES |
| Ohio | MEDICAID | 0882166 | |
| Ohio | MEDICAID | 104874703 | |
| Ohio | Other | 000000011080 | |
| Ohio | MEDICAID | 200033290 | |
| Ohio | Other | 000000082535 |
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