Individual
MARC DAVID MALKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
855 MONROE AVE, SUITE 415 LINK BUILDING, MEMPHIS, TN 38103-4901
(901) 448-2625
(901) 448-7440
Mailing address
PO BOX 1000, DEPT # 457, MEMPHIS, TN 38148-0001
(901) 448-6198
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
51347
TN
2084V0102X
Vascular Neurology Physician
51347
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00601253
—
MS
05
—
122553001
—
AR
01
—
6024333
BCBS
TN
01
—
P01484270
RAILROAD MEDICARE
TN
05
—
Q005342
—
TN
Enumeration date
08/24/2006
Last updated
09/25/2015
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