MEDICARE: MRS. ANDREA G. MALONE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	34009912	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316162472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANDREA G. MALONE D.O.

Provider Business Mailing Address
First Line	:	4343 ALL SEASONS DR STE 250
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-1952
Country	:	US
Telephone Number	:	614-533-5500
Fax Number	:	614-533-0217

Provider Business Practice Location Address
First Line	:	3663 RIDGE MILL DR
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7799
Country	:	US
Telephone Number	:	614-533-5500
Fax Number	:	614-533-0103

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	01/25/2022

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