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General NPI Number Information
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NPI Number | 1780651471
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Entity Type | Individual
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Provider Name | FERNANDO C MALAMUD M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2202 STATE AVE SUITE 111
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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 |
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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 |
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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 | 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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