Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | C1-0008853 | DE |
Y | 207XS0117X | Orthopaedic Spine Surgeon | C1-0008853 | DE |
NPI | 1356377204 |
---|---|
Provider Name | Stephen L Malone |
First Address | Dover, DE 19904-7790 |
Second Address | Dover, DE 19904-7790 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 11/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2111951 | (05) | MA |
H51965 | INDIVIDUAL (01) | MA |