Individual
DR. ELSA K. MALCOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
730 W MARKET ST, LIMA, OH 45801-4602
(419) 221-2042
(419) 996-5298
Mailing address
10335 N PORT WASHINGTON RD, SUITE 250, MEQUON, WI 53092-5763
(262) 240-9870
(262) 240-9869
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35-07-9416-M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2242602
—
OH
Enumeration date
07/14/2006
Last updated
11/01/2007
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