Individual
DR. DANA R MALKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
417 SKYLINE BLVD, CLOQUET, MN 55720-1164
(218) 879-1271
(218) 879-8904
Mailing address
417 SKYLINE BLVD, CLOQUET, MN 55720-1164
(218) 879-1271
(218) 879-8904
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23590
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102326
MEDICA
FM
05
—
294395600
—
MN
01
—
52586MA
BLUES & FIRST PLAN
MN
Enumeration date
10/19/2006
Last updated
09/27/2011
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