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Individual

SHIRLEY ANN MALCOLM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
70 BOWER DR, MEDFORD, OR 97501-3689
(541) 734-3430
(541) 512-1026
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 734-3430

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO17513
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
057830
OR
Enumeration date
07/27/2006
Last updated
10/19/2020
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