Individual
THU MALIKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
234401
MA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
69249-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110078583A
—
MA
Enumeration date
07/12/2006
Last updated
07/18/2023
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