MEDICARE: DR. JUAN CARLOS MALPARTIDA M.D.

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	207R00000X	Internal Medicine Physician	50406	GA

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	:	1568551919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN CARLOS MALPARTIDA M.D.

Provider Business Mailing Address
First Line	:	1100 E WALNUT AVE STE 15
Second Line	:
City	:	DALTON
State	:	GA
Zip	:	30721-4185
Country	:	US
Telephone Number	:	706-313-3595
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 E WALNUT AVE
Second Line	:	SUITE #15
City	:	DALTON
State	:	GA
Zip	:	30721-4183
Country	:	US
Telephone Number	:	706-259-5579
Fax Number	:	706-259-6558

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	12/04/2025

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