MEDICARE: DR. ROBERT MICHAEL MALACHOWSKI 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	208000000X	Pediatrics Physician	01023531A	IN

General Provider Information

NPI Number	:	1992708333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT MICHAEL MALACHOWSKI M.D.

Provider Business Mailing Address
First Line	:	5722 BRENDON FOREST DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46226-1045
Country	:	US
Telephone Number	:	317-545-9467
Fax Number	:

Provider Business Practice Location Address
First Line	:	5722 BRENDON FOREST DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46226-1045
Country	:	US
Telephone Number	:	317-545-9467
Fax Number	:

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	07/08/2007

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