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Individual

HAVEN R MALISH

Active
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Individual

HAVEN R MALISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

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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