Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 27918 | MN |
N | 207YP0228X | Pediatric Otolaryngology | 27918 | MN |
N | 2086S0120X | Pediatric Surgery | 27918 | MN |
NPI | 1831135193 |
---|---|
Provider Name | Mrs. Barbara Newman Malone |
First Address | Woodbury, MN 55125 |
Second Address | Woodbury, MN 55125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4077288000 | (05) | MN |
A94630 | (02) |