Healthcare Provider Details

I. General information

NPI: 1659312502
Provider Name (Legal Business Name): WARREN R MALEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 03/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 WALNUT ST MOB, 5TH FLOOR, SUITE 500
PHILADELPHIA PA
19107-5563
US

IV. Provider business mailing address

1100 WALNUT ST MOB, 5TH FLOOR, SUITE 500
PHILADELPHIA PA
19107-5563
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-6750
  • Fax: 215-923-8222
Mailing address:
  • Phone: 215-955-6750
  • Fax: 215-923-8222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberC10009194
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberMD072536L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: