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Individual

EDWARD J MALONE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
815 10TH STREET S., LA CROSSE, WI 54601-4700
(608) 392-7390
Mailing address
815 10TH STREET S., LA CROSSE, WI 54601-4700
(608) 392-7390

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34774
WI
207Q00000X
Family Medicine Physician
38245
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
171717100
MN
Enumeration date
04/01/2006
Last updated
09/15/2020
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