Individual
TRUDY MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
N30W29293 HILLCREST DR, PEWAUKEE, WI 53072-3235
(262) 369-0030
Mailing address
N30W29293 HILLCREST DR, PEWAUKEE, WI 53072-3235
(262) 369-0030
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
37377
MN
207V00000X
Obstetrics & Gynecology Physician
Primary
39304-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39304-20
WISCONSIN MEDICINE AND SURGERY LICENSE
WI
Enumeration date
03/24/2019
Last updated
03/24/2019
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