Individual
DR. TIMOTHY JOHN MALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2005 BLUE MOUNTAIN AVE, BERTHOUD, CO 80513-8629
(970) 218-7081
Mailing address
1627 E 18TH ST, LOVELAND, CO 80538-4209
(970) 663-0135
(970) 461-1422
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31279
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01312792
—
CO
Enumeration date
07/11/2005
Last updated
07/02/2008
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