Individual
MR. KINGSLEY L MALCOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1001 WEST ST, CARTHAGE, NY 13619-9703
(315) 493-1000
Mailing address
2824 RADER RIDGE CT, ANTIOCH, TN 37013-5748
(615) 424-3918
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
511702-1
NY
Other
Enumeration date
01/04/2010
Last updated
01/12/2010
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