Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 01043550A | IN |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 01043550A | IN |
NPI | 1336141050 |
---|---|
Provider Name | Dr. Michael C Malczewski |
First Address | Hobart, IN 46342-6665 |
Second Address | Hobart, IN 46342-6665 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 02/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200025060 | (05) | IN |
G00519 | (02) | IN |