Individual
TIMOTHY D MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
17355
SC
2084P0800X
Psychiatry Physician
Primary
17355
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173555
—
SC
01
—
582296052
PBMC BEHAVIORAL HEALTH
SC
Enumeration date
01/25/2006
Last updated
09/17/2021
Update your record
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