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General NPI Number Information
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NPI Number | 1366428492
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Entity Type | Individual
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Provider Name | WILLIAM G MALCOLM DPM
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Gender | Male
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 4900 SW 101ST AVE
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City | COOPER CITY
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State | FL
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Zip | 33328-3307
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Country | US
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Telephone | 305-866-0268
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 SW 101ST AVE
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City | COOPER CITY
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State | FL
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Zip | 33328-3307
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Country | US
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Telephone | 954-804-2232
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Fax | 305-865-0844
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO2054
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License Number State | FL
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