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Individual

THOMAS A MALEC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., P.C.

Contact information

Practice address
515 LAKESIDE DR SE, SUITE 207, GRAND RAPIDS, MI 49506-2931
(616) 459-3564
(616) 459-3868
Mailing address
515 LAKESIDE DR SE, SUITE 207, GRAND RAPIDS, MI 49506-2931
(616) 459-3564
(616) 459-3868

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301026401
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1059530
MI
Enumeration date
09/06/2005
Last updated
08/28/2008
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