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General NPI Number Information
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NPI Number | 1982610663
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Entity Type | Individual
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Provider Name | MARK W. MALONEY D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 06/28/2017
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Provider Practice Location Address
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Address Line | 145 HOSPITAL AVE SUITE 313
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City | DU BOIS
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State | PA
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Zip | 15801-1462
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Country | US
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Telephone | 814-375-3913
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Fax | 814-375-5258
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Provider Business Mailing Address
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Address Line | PO BOX 447
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City | DU BOIS
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State | PA
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Zip | 15801-0447
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Country | US
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Telephone | 814-375-3913
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Fax | 814-375-5258
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS-009147-L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | OS009147L
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License Number State | PA
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