Individual
DR. BRETT JONATHAN MALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3021 VOYAGER DR, GREEN BAY, WI 54311-8303
(920) 496-4700
Mailing address
3021 VOYAGER DR, GREEN BAY, WI 54311-8303
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
60831-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2009
Last updated
07/08/2013
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