Provider Demographics
NPI:1831148097
Name:FIJALKOWSKI, DANNY ROGER (DPM)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:ROGER
Last Name:FIJALKOWSKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51339 NATIONAL RD E
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9119
Mailing Address - Country:US
Mailing Address - Phone:740-695-1210
Mailing Address - Fax:740-695-4304
Practice Address - Street 1:51339 NATIONAL RD E
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9119
Practice Address - Country:US
Practice Address - Phone:740-695-1210
Practice Address - Fax:740-695-4304
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005912213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery