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General NPI Number Information
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NPI Number | 1922788892
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Entity Type | Individual
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Provider Name | DIMA MALKAWI MD
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Gender | Female
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 12631 E 17TH AVE RM 6111
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City | AURORA
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State | CO
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Zip | 80045-2527
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Country | US
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Telephone | 303-724-2750
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Fax |
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Provider Business Mailing Address
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Address Line | 9501 E 23RD AVE UNIT 318
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City | AURORA
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State | CO
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Zip | 80010-1081
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Country | US
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Telephone | 202-538-1233
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | TL0010006
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License Number State | CO
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