Provider Demographics
NPI:1578023990
Name:CALDERONE, ALEXANDER KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:KENNETH
Last Name:CALDERONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14050 NICOLLET AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-5739
Mailing Address - Country:US
Mailing Address - Phone:952-435-2450
Mailing Address - Fax:
Practice Address - Street 1:14050 NICOLLET AVE STE 300
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-5739
Practice Address - Country:US
Practice Address - Phone:952-435-2450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN70967208000000X
OH57.247221390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics