Healthcare Provider Details

I. General information

NPI: 1447094347
Provider Name (Legal Business Name): MADELINE MALEK AU.D., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3730 RHONE CIR STE 104
ANCHORAGE AK
99508-5054
US

IV. Provider business mailing address

3730 RHONE CIR STE 104
ANCHORAGE AK
99508-5054
US

V. Phone/Fax

Practice location:
  • Phone: 907-563-8008
  • Fax: 907-563-8007
Mailing address:
  • Phone: 907-563-8008
  • Fax: 907-563-8007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number225062
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number225062
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: