Healthcare Provider Details

I. General information

NPI: 1093854911
Provider Name (Legal Business Name): WILLIAM F MALCOLM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 10/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DUKE UNIVERSITY MEDICAL CTR DUMC 3127
DURHAM NC
27710-0001
US

IV. Provider business mailing address

DUKE UNIVERSITY MEDICAL CTR DUMC 3127
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-6024
  • Fax:
Mailing address:
  • Phone: 919-681-6024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier89129RG
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: