Individual
SIDNEY MALLENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 RIVERSIDE CIR, ROANOKE, VA 24016-4955
(540) 224-5170
Mailing address
3 RIVERSIDE CIR, ROANOKE, VA 24016-4955
(540) 224-5170
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0101045430
VA
2084N0400X
Neurology Physician
ME137451
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011645-00
—
FL
Enumeration date
11/09/2006
Last updated
12/09/2020
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