Malone, Dwight M
Malone, Dwight M is an individual health care provider with primary practice located at 1505 N Country Club Dr Apt 118 , Mesa AZ 85201-2518. He recently has only one registered license in Other Service Providers / Driver, which is considered as his primary health care specialty. Malone, Dwight M can be contacted via phone (480) 547-4960.Contact Information
Primary practice address
1505 N Country Club Dr Apt 118
Mesa AZ 85201-2518
Phone: (480) 547-4960
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Driver | 172A00000X | L2088992 | Arizona |
Profile Details
| NPI number | 1154774107 |
|---|---|
| LBN Legal business name | Malone, Dwight M |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2016 |
| Last updated | Jul 14th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154774107 | NPPES |
| Arizona | MEDICAID | 812493202 |
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