Individual
ERIC S. MALICKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(262) 329-8300
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
39848
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32437000
—
WI
01
—
P00452795
RR MEDICARE
WI
Enumeration date
07/04/2006
Last updated
06/23/2024
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