Individual
PAUL D MALSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
5000 BLACKMORE RD, CASPER, WY 82609-3345
(307) 233-6000
(307) 233-6089
Mailing address
5000 BLACKMORE RD, CASPER, WY 82609-3345
(307) 233-6000
(307) 233-6089
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0010-04186
NC
363AM0700X
Medical Physician Assistant
PA.0003502
CO
363AM0700X
Medical Physician Assistant
Primary
PA643
WY
Other
Enumeration date
07/30/2012
Last updated
11/28/2018
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