Healthcare Provider Details

I. General information

NPI: 1699018531
Provider Name (Legal Business Name): ALEXANDER M MALEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12901 W NATIONAL AVE
NEW BERLIN WI
53151-4063
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-5044
US

V. Phone/Fax

Practice location:
  • Phone: 262-787-5200
  • Fax:
Mailing address:
  • Phone: 800-326-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number66410
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: