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General NPI Number Information
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NPI Number | 1134410863
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Entity Type | Individual
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Provider Name | KATHRYN SHANNON MALOY M.D., MPH
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Gender | Female
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 15675 NORTHLINE RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-2334
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Country | US
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Telephone | 734-282-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 JEFFERSON AVE FL 5
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City | TOLEDO
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State | OH
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Zip | 43604-7102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35132074
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301507876
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License Number State | MI
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