Provider Demographics
NPI:1235797168
Name:POMAKOV, ALEXANDER O (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:O
Last Name:POMAKOV
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:ERIE COUNTY MEDICAL CENTER, DAVID K. MILLER BUILDING,
Mailing Address - Street 2:462 GRIDER ST.
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215
Mailing Address - Country:US
Mailing Address - Phone:716-898-3941
Mailing Address - Fax:716-898-3279
Practice Address - Street 1:3101 BEAUMONT CENTRE CIR STE 100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1959
Practice Address - Country:US
Practice Address - Phone:859-323-5544
Practice Address - Fax:859-257-9286
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY59725207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program