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General NPI Number Information
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NPI Number | 1437135183
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Entity Type | Individual
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Provider Name | RICKY MALONE MD
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Gender | Male
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 6900 GEORGIA AVE NW WASHINGTON
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City | WASHINGTON
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State | DC
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Zip | 20307-5001
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Country | US
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Telephone | 202-782-8030
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Fax |
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Provider Business Mailing Address
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Address Line | 15000 POTOMAC TOWN PL STE 100-234
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City | WOODBRIDGE
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State | VA
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Zip | 22191-6586
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Country | US
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Telephone | 571-766-6520
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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 | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | H0595
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 0101259568
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | H0595
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2084F0202X
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Taxonomy Name | Forensic Psychiatry Physician
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License Number | 0101259568
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License Number State | VA
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