MEDICARE: MALONE-DAVIS NEUROLOGY PLLC

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	16583	NV

General Provider Information

NPI Number	:	1932622750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MALONE-DAVIS NEUROLOGY PLLC

Provider Business Mailing Address
First Line	:	7730 W CHEYENNE AVE STE 107
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-8412
Country	:	US
Telephone Number	:	725-221-1568
Fax Number	:	725-333-9218

Provider Business Practice Location Address
First Line	:	7730 W CHEYENNE AVE STE 107
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-8412
Country	:	US
Telephone Number	:	725-221-1568
Fax Number	:	725-333-9218

Authorized Official
Title or Position	:	OFFICER
Name	:	TOYA MALONE-DAVIS
Credential	:	MD
Telephone Number	:	725-221-1568

Provider Enumeration Date	:	07/24/2017
Last Update Date	:	04/23/2024

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