Healthcare Provider Details

I. General information

NPI: 1407935109
Provider Name (Legal Business Name): PAUL F MALONE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 PINEVIEW DR
MORGANTOWN WV
26505
US

IV. Provider business mailing address

1188 PINEVIEW DR
MORGANTOWN WV
26505
US

V. Phone/Fax

Practice location:
  • Phone: 304-599-3959
  • Fax: 304-599-1719
Mailing address:
  • Phone: 304-599-3959
  • Fax: 304-599-1719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number10035
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: