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Individual

DR. KEVIN D MALONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1104 W EVERGREEN AVE, EFFINGHAM, IL 62401-1710
(217) 347-2500
(217) 342-9775
Mailing address
1005 HEALTH CENTER DR STE 201, MATTOON, IL 61938-4693
(217) 238-6055
(217) 258-2216

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036092819
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036092819
IL
Enumeration date
08/09/2006
Last updated
09/07/2021
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