Healthcare Provider Details

I. General information

NPI: 1174181663
Provider Name (Legal Business Name): THOMAS GERARD MALONEY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 W HIGH ST STE 240
LIMA OH
45801-5906
US

IV. Provider business mailing address

770 W HIGH ST STE 240
LIMA OH
45801-5906
US

V. Phone/Fax

Practice location:
  • Phone: 419-996-2686
  • Fax: 419-996-2687
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number94-12104
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number34.018561
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDO-06019
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDO-06019
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: