Individual
TAMARA MALESEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(216) 544-5387
Mailing address
12700 LAKE AVE APT 1102, LAKEWOOD, OH 44107-1530
(216) 544-5387
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA.19068-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093168213
ADULT/GERONTOLOGY
OH
Enumeration date
07/22/2016
Last updated
07/09/2020
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