MEDICARE: KIM M LAMOTTE-MALONE MD

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	208000000X	Pediatrics Physician	5929	NV

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	:	1427008887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM M LAMOTTE-MALONE MD

Provider Business Mailing Address
First Line	:	871 CORONADO CENTER DR STE 141
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3977
Country	:	US
Telephone Number	:	702-566-2400
Fax Number	:	702-433-2477

Provider Business Practice Location Address
First Line	:	871 CORONADO CENTER DR STE 141
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3977
Country	:	US
Telephone Number	:	702-566-2400
Fax Number	:	702-433-2477

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	03/25/2020

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