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General NPI Number Information
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NPI Number | 1568551919
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Entity Type | Individual
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Provider Name | JUAN CARLOS MALPARTIDA M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1100 E WALNUT AVE SUITE #15
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City | DALTON
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State | GA
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Zip | 30721-4183
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Country | US
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Telephone | 706-259-5579
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Fax | 706-259-6558
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Provider Business Mailing Address
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Address Line | 1100 E WALNUT AVE STE 15
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City | DALTON
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State | GA
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Zip | 30721-4185
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Country | US
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Telephone | 706-313-3595
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 50406
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License Number State | GA
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