Individual
DR. DAVID MALICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5450 FORT ST, EMERGENCY MEDICINE DEPARTMENT, TRENTON, MI 48183-4601
(734) 671-3883
(734) 671-3546
Mailing address
2764 NEW ENGLAND DR, ROCHESTER HILLS, MI 48309-2818
(734) 632-0175
(734) 632-0182
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101006437
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043298342
—
MI
01
—
1156338864
BCBS
MI
Enumeration date
01/06/2006
Last updated
02/25/2019
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