Individual
DR. MICHAEL A. MALAMISURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
510 CHERRY STREET, BLUEFIELD, WV 24701-9999
(304) 325-3666
(304) 327-2497
Mailing address
510 CHERRY STREET, BLUEFIELD, WV 24701-9999
(304) 325-3666
(304) 327-2497
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
11940
WV
207RG0100X
Gastroenterology Physician
Primary
11940
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9383331
MEDICARE PTAN
—
Enumeration date
06/12/2006
Last updated
03/07/2023
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