Individual
ALISHA FAY MALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
10400 75TH ST, AURORA MEDICAL CENTER, KENOSHA, WI 53142
(262) 697-7000
(630) 734-1560
Mailing address
PO BOX 3043, MEA AEA KENOSH SC, OAK BROOK, IL 60522-3043
(630) 734-0200
(630) 734-1560
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1690023
WI
363A00000X
Physician Assistant
Primary
1690-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41987700
—
WI
Enumeration date
12/01/2005
Last updated
07/31/2018
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