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Physician Compare National (NPI:1073045894)

HEALTHCARE PROVIDER: DORINDA MALCOLM M.A.,CCC-SLP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1073045894
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 1557631363
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20170726002452
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name MALCOLM
Individual professional last name
Provider First Name DORINDA
Individual professional first name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Individual professional's medical school
Graduation Year 1997
Individual professional's medical school graduation year
Primary Specialty QUALIFIED SPEECH LANGUAGE PATHOLOGIST
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 8644 WATER FALL DR
Group Practice or individual's line 1 address
Marker of address line 2 suppression Y
Marker that address as reported may be incomplete
City LAUREL
Group Practice or individual's city
State MD
Group Practice or individual's state
Zip Code 207232033
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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