Healthcare Provider Details

I. General information

NPI: 1053387845
Provider Name (Legal Business Name): JAMES FRANCIS MALSEED M.ED., ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 08/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 PHILADELPHIA PIKE ARCHMERE ACADEMY
CLAYMONT DE
19703-3108
US

IV. Provider business mailing address

3600 PHILADELPHIA PIKE ARCHMERE ACADEMY
CLAYMONT DE
19703-3108
US

V. Phone/Fax

Practice location:
  • Phone: 302-798-6632
  • Fax: 302-798-7290
Mailing address:
  • Phone: 302-798-6632
  • Fax: 302-798-7290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberJ3-0000004
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: