Individual
JORDAN MALENKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
92 CAMPUS DR FL 3, SCARBOROUGH, ME 04074-7228
(207) 797-5753
Mailing address
92 CAMPUS DR FL 3, SCARBOROUGH, ME 04074-7228
(207) 797-5753
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
88850
GA
207Y00000X
Otolaryngology Physician
Primary
MD26065
ME
207YX0602X
Otolaryngic Allergy Physician
88850
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2016
Last updated
07/29/2022
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