MEDICARE: DR. IRWIN BERNARD MALAMENT D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	7000441	IN

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	:	1598739039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IRWIN BERNARD MALAMENT D.P.M.

Provider Business Mailing Address
First Line	:	3410 N HIGH SCHOOL RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46224-1100
Country	:	US
Telephone Number	:	317-299-2644
Fax Number	:	317-328-8914

Provider Business Practice Location Address
First Line	:	3410 N HIGH SCHOOL RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46224-1742
Country	:	US
Telephone Number	:	317-299-2644
Fax Number	:	317-328-8914

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	09/23/2009

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