Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | ME 62779 | FL |
NPI | 1023121936 |
---|---|
Provider Name | Dr. Richard Weaver Maloney |
First Address | Naples, FL 34110-5738 |
Second Address | Naples, FL 34110-5738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C29653 | (02) | FL |