Individual
DR. CHRISTOPHER JAMES MALCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4519 ENTERPRISE WAY, CALDWELL, ID 83605-8055
(208) 455-7482
(208) 455-7538
Mailing address
4519 ENTERPRISE WAY, CALDWELL, ID 83605-8055
(208) 455-7482
(208) 455-7538
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
O-0744
ID
2085R0202X
Diagnostic Radiology Physician
Primary
O-0744
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
817783
—
AZ
Enumeration date
10/21/2008
Last updated
07/10/2014
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