Individual
JOHN DAVID MALOUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1219 N 400 E, LOGAN, UT 84341-2321
(435) 565-6043
(435) 220-2030
Mailing address
2855 N 920 E, NORTH LOGAN, UT 84341-5806
(435) 557-0354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
317131-1204
UT
207Q00000X
Family Medicine Physician
5101018972
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992097612
—
MI
Enumeration date
05/12/2011
Last updated
08/30/2021
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