Individual
DR. KENNETH C. MALMSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 MEDICAL CENTER BLVD, MARRERO, LA 70072-3147
(504) 349-1656
(504) 349-1933
Mailing address
1101 MEDICAL CENTER BLVD., HOSPITALIST DEPARTMENT, MARRERO, LA 70072
(504) 349-1656
(504) 349-1933
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
14714R
LA
208M00000X
Hospitalist Physician
MD.14714R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09288765
—
MS
05
—
1148571
—
LA
Enumeration date
09/27/2005
Last updated
07/21/2022
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