Individual
JOHN A MALM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
405 WHITTECAR AVE, GREGORY, SD 57533-1340
(605) 835-9611
(605) 835-8033
Mailing address
405 WHITTECAR AVE, GREGORY, SD 57533-1340
(605) 835-9611
(605) 835-8033
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
15493
NE
207Q00000X
Family Medicine Physician
Primary
2174
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5604663
—
SD
Enumeration date
04/17/2006
Last updated
07/08/2007
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