Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2013-00297 | NC |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 0101253896 | VA |
NPI | 1316142565 |
---|---|
Provider Name | Dr. Paul Maloof |
First Address | Hampton, VA 23666-6249 |
Second Address | Hampton, VA 23666-6249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 31/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VV9920A | MEDICARE PTAN (01) | VA |