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Brian Henry Malone

Student in an Organized Health Care Education/Training Program in Philadelphia, PA. Individual provider (NPI-1).

NPI number1164089694
StatusActive
Last updated in NPPESJul 9, 2024

Details

NPI
1164089694
Entity type
Individual (NPI-1)
Name
Brian Henry Malone
Sex
Male
Sole proprietor
No
Enumeration date
May 21, 2019
Certification date
Jul 9, 2024
Last updated
Jul 9, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training ProgramOT019069PAYes
207L00000X AnesthesiologyOS023736PA

Practice location

111 S 11th St Ste 8290
Philadelphia, PA 19107-4824

Phone 215-955-2370 · Fax 215-955-0677

Mailing address

111 S 11th St Ste 8290
Philadelphia, PA 19107-4824

Phone 215-955-2370 · Fax 215-955-0677

Other practice locations

111 S 11th St Ste 8270
Philadelphia, PA 19107-4824

Phone 215-955-2370 · Fax 215-955-0677

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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