Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 34006675 | OH |
Y | 207R00000X | Internist | 34006675 | OH |
Y | 111NI0900X | Internist | 34006675 | OH |
NPI | 1104801984 |
---|---|
Provider Name | Dr. Vincent Joseph Malkovits |
First Address | Austintown, OH 44515-2366 |
Second Address | Austintown, OH 44515-2366 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 07/02/2022 |