Individual
KYLE M MALECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11700 N MERIDIAN ST, CARMEL, IN 46032-4656
(317) 688-2955
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.071862
IL
2085R0202X
Diagnostic Radiology Physician
Primary
01089671A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300026706
—
IN
01
—
959090186
MEDICARE PTAN
IN
Enumeration date
03/20/2018
Last updated
08/17/2023
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