Individual
CHARLES D MALIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
107 COMMERCIAL ST, MASHPEE, MA 02649
(508) 477-7090
(508) 477-3090
Mailing address
56 WINTHROP ST, UNIT 1 THE CONCORD CLINIC, CONCORD, MA 01742-2076
(978) 369-2266
(978) 369-5205
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
58602
MA
207R00000X
Internal Medicine Physician
58602
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3024741
—
MA
Enumeration date
01/27/2006
Last updated
06/15/2018
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