Individual
HAVEN R MALISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
222 N 7TH ST, BISMARCK, ND 58501-4436
(701) 323-6000
Mailing address
222 N 7TH ST, BISMARCK, ND 58501-4436
(701) 323-6000
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
12111A
WY
207RP1001X
Pulmonary Disease Physician
TL5628
WY
207RS0012X
Sleep Medicine (Internal Medicine) Physician
12111A
WY
207RS0012X
Sleep Medicine (Internal Medicine) Physician
15016
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152139000
—
WY
Enumeration date
10/03/2006
Last updated
02/15/2021
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