Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301043760 | MI |
N | 111NI0900X | Internist | 4301043760 | MI |
N | 207RA0401X | Internist - Addiction Medicine | HM043760 | MI |
NPI | 1518991686 |
---|---|
Provider Name | Herbert L Malinoff |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48108-5721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 16/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110H113170 | BLUE CROSS (01) | MI |
124941 | CARE CHOICES (01) | MI |
124941 | PREFERRED CHOICES (01) | MI |
202364029 | TAX ID (01) | MI |
A78517 | (02) | MI |
HM043760 | STATE LICENSE (01) | MI |