Individual provider · NPI-1

Kenric D Malmberg, MD

Family Medicine · Brookings, SD

NPI number1376585885
StatusActive
Last updated in NPPESJun 26, 2014

Details

NPI
1376585885
Entity type
Individual (NPI-1)
Name
Mr. Kenric D Malmberg
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jun 11, 2006
Last updated
Jun 26, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine7340AWYYes

Practice location

400 22nd Ave
Brookings, SD 57006-2497

Phone 605-697-9500 · Fax 605-697-6939

Mailing address

400 22nd Ave
Brookings, SD 57006-2497

Phone 605-697-9500 · Fax 605-697-6939

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