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General NPI Number Information
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NPI Number | 1437187192
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Entity Type | Organization
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Legal Business Name | FERNANDO C MALAMUD MD PA
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2202 STATE AVE SUITE 11
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City | PANAMA CITY
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State | FL
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Zip | 32405-7601
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Country | US
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Telephone | 850-784-9977
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Fax | 850-784-9980
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Provider Business Mailing Address
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Address Line | PO BOX 15115
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City | PANAMA CITY
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State | FL
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Zip | 32406-5115
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Country | US
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Telephone | 850-784-9977
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Fax | 850-784-9980
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FERNANDO C MALAMUD
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Credential | M.D.
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Telephone | 850-784-9977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | ME76858
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License Number State | FL
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