Individual
MR. MARK D MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
Mailing address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0002005
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72328541
—
CO
Enumeration date
07/10/2006
Last updated
10/25/2016
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