Provider Demographics
NPI:1508166984
Name:HORBAL, ALEXANDER A (DO)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:A
Last Name:HORBAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 W WACKERLY ST STE 2675
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4712
Mailing Address - Country:US
Mailing Address - Phone:989-631-1010
Mailing Address - Fax:989-839-8800
Practice Address - Street 1:555 W WACKERLY ST STE 2675
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4712
Practice Address - Country:US
Practice Address - Phone:989-631-1010
Practice Address - Fax:989-839-8800
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151012042207K00000X, 207R00000X
242T00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionistGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty