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Individual

MALACHIA TROUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2400 32ND AVE S, FARGO, ND 58103-5800
(701) 234-8800
Mailing address
426 LIBERTY LN, HORACE, ND 58047-4523

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12886
ND
207R00000X
Internal Medicine Physician
5984
NE
208000000X
Pediatrics Physician
5984
NE

Other

Enumeration date
07/06/2009
Last updated
01/15/2014
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