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Individual
DR. DANA R MALKOVICH
Active
Individual
DR. DANA R MALKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23590
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102326
MEDICA
FM
05
—
294395600
—
MN
01
—
52586MA
BLUES & FIRST PLAN
MN
Enumeration date
10/19/2006
Last updated
09/27/2011
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