Individual
DR. RICHARD GLADE MALISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-6917
Mailing address
301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-6917
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
29642
TN
207RC0000X
Cardiovascular Disease Physician
Primary
29642
TN
Other
Enumeration date
08/24/2006
Last updated
01/04/2016
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