MEDICARE: PAUL G MALONE PA-C

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	363A00000X	Physician Assistant	0110002686	VA

General Provider Information

NPI Number	:	1962594895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL G MALONE PA-C

Provider Business Mailing Address
First Line	:	582 BLUE RIDGE AVE
Second Line	:
City	:	BEDFORD
State	:	VA
Zip	:	24523-2604
Country	:	US
Telephone Number	:	540-425-7910
Fax Number	:	540-583-5147

Provider Business Practice Location Address
First Line	:	582 BLUE RIDGE AVE
Second Line	:
City	:	BEDFORD
State	:	VA
Zip	:	24523-2604
Country	:	US
Telephone Number	:	540-425-7910
Fax Number	:	540-583-5147

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	10/27/2016

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Directions to “ PAUL G MALONE PA-C” Practice Location

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