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Individual

MARK A MALANGONI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
51 N 39TH ST, MOB 1ST FLOOR, PHILADELPHIA, PA 19104-2640
(215) 662-7320
Mailing address
51 N 39TH ST, MOB 1ST FLOOR, PHILADELPHIA, PA 19104-2640
(215) 662-7320

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD443692
PA
2086S0102X
Surgical Critical Care Physician
MD443692
PA
2086S0127X
Trauma Surgery Physician
MD443692
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0782103
OH
Enumeration date
07/02/2006
Last updated
08/29/2016
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