Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 19350 | MS |
NPI | 1033325022 |
---|---|
Provider Name | Malcolm M Roland |
First Address | Oxford, MS 38655-6902 |
Second Address | Oxford, MS 38655-6902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 10/06/2014 |