Provider Demographics
NPI:1518182062
Name:PLANG, CHE ABDULSHAIK FAJARDO (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CHE ABDULSHAIK
Middle Name:FAJARDO
Last Name:PLANG
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:MR
Other - First Name:CHE
Other - Middle Name:
Other - Last Name:PLANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9109 MENDENHALL MALL RD STE 5K
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7136
Mailing Address - Country:US
Mailing Address - Phone:907-957-6942
Mailing Address - Fax:888-758-3063
Practice Address - Street 1:9109 MENDENHALL MALL RD STE 5K
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7136
Practice Address - Country:US
Practice Address - Phone:907-957-6942
Practice Address - Fax:888-758-3063
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025533-1225100000X
AK2288225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist