Provider Demographics
NPI:1619962347
Name:FIALKOWSKI, WILLIAM E (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:FIALKOWSKI
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:PO BOX 11407 DRAWER 624
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1806 SIXTH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-0001
Practice Address - Country:US
Practice Address - Phone:205-975-7389
Practice Address - Fax:205-975-4662
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.8144207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009935889Medicaid
AL1619962347OtherTRICARE SOUTH
AL051515576Medicaid
AL051515576OtherBCBS PROVIDER NUMBER
AL051553226Medicaid
AL515-14708OtherBCBS
ALP00026568OtherRAILROAD MEDICARE
AL116877Medicaid
AL4234890OtherAETNA
AL930127980Medicare PIN
ALP00026568OtherRAILROAD MEDICARE
AL4234890OtherAETNA
AL051515576OtherBCBS PROVIDER NUMBER
AL009935889Medicaid