Individual
DR. BRIAN IMBAO MALTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
628 HOSPITAL DR STE 3A, MOUNTAIN HOME, AR 72653-2952
(870) 425-1787
Mailing address
555 W 6TH ST, MOUNTAIN HOME, AR 72653-3409
(870) 425-1787
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
2012037638
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/12/2010
Last updated
05/12/2021
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