MEDICARE: DR. DANIELLE LOUISE MALIN DPM

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	776	TN

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	:	1851688345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIELLE LOUISE MALIN DPM

Provider Business Mailing Address
First Line	:	1412 TROTWOOD AVE STE 39
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-4948
Country	:	US
Telephone Number	:	931-901-0296
Fax Number	:	931-901-0299

Provider Business Practice Location Address
First Line	:	1412 TROTWOOD AVE STE 39
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-4948
Country	:	US
Telephone Number	:	931-901-0296
Fax Number	:	931-901-0299

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

Provider Enumeration Date	:	07/05/2011
Last Update Date	:	12/14/2023

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