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General NPI Number Information
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NPI Number | 1285602771
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Entity Type | Individual
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Provider Name | STEPHEN W MALAQUIAS MD
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Gender | Male
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 05/03/2010
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Provider Practice Location Address
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Address Line | 257 STATION AVENUE
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City | SOUTH YARMOUTH
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State | MA
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Zip | 02664
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Country | US
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Telephone | 508-394-8303
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Fax | 508-398-6680
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Provider Business Mailing Address
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Address Line | 25 COMMUNICATIONS WAY MACC - REVENUE CYCLE
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City | HYANNIS
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State | MA
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Zip | 02601-1866
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Country | US
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Telephone | 508-957-8664
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Fax | 508-957-8677
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 40224
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License Number State | MA
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