Provider Demographics
NPI:1841217270
Name:BANKOV, ALEXANDER BORISOVICH (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:BORISOVICH
Last Name:BANKOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALEKSANDR
Other - Middle Name:
Other - Last Name:BANKOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:114 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-1337
Mailing Address - Country:US
Mailing Address - Phone:724-709-9885
Mailing Address - Fax:724-774-1517
Practice Address - Street 1:114 MAPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-1337
Practice Address - Country:US
Practice Address - Phone:724-709-9885
Practice Address - Fax:724-774-1517
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD073454L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019034270001Medicaid
PA01903427-09OtherAMERICHOICE
PA30563OtherHEALTH PARTNERS FRANKFORD
PA1401878OtherHIGHMARK BLUE SHIELD
PA2090439000OtherKEYSTONE IBC
PA30002948OtherKEYSTONE MERCY
PA01697OtherHEALTH PARTNERS TORRES.
PA050090907OtherRAILROAD MEDICARE
PA3056444OtherAETNA CONTRACT
PA30567OtherHEALTH PARTNERS BUCKS
PA0019034270002Medicaid
PA1401878OtherPERSONAL CHOICE
PA1588043OtherCIGNA
PA2203491OtherUNITED HEALTHCARE
PA30002948OtherKEYSTONE MERCY
PAH62426Medicare UPIN