Individual
MICHAEL D MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3250 GORDONVILLE RD STE 358, CAPE GIRARDEAU, MO 63703-5095
(573) 331-3155
(573) 331-5096
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
35083959
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000329488
ANTHEM BC/BS
OH
05
—
2455589
—
OH
01
—
383693735027
CARESOURCE
OH
01
—
5539685
AETNA
OH
01
—
P00102611
RAILROAD CARE
OH
Enumeration date
05/25/2006
Last updated
03/01/2021
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