# DR. RONALD LEE MALM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1457459125
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 5752A | WY | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 07/17/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 080143307 | RR MEDICARE | WY |
| 05 | — | 110737200 | — | WY |
| 01 | — | 308136 | BCBS | WY |