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Individual

DR. STEPHEN TODD MALUTICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1200 S. COLUMBIA ROAD, GRAND FORKS, ND 58201
(701) 780-5000
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-6468

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17584
ND
207R00000X
Internal Medicine Physician
2018031092
MO
390200000X
Student in an Organized Health Care Education/Training Program
UO5031
FL

Other

Enumeration date
06/24/2016
Last updated
09/09/2021
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