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Individual

ANTHONY MALENCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10 PROFESSIONAL PARK DR, MARYVILLE, IL 62062-5672
(618) 288-7244
(618) 288-1980
Mailing address
103B SOUTHPOINTE, EDWARDSVILLE, IL 62025-3651
(618) 692-9640
(618) 692-9643

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036063954
IL

Other

Enumeration date
11/02/2006
Last updated
07/08/2007
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