Provider Demographics
NPI:1023393220
Name:MALENOWSKI, DAVID MICHAEL I (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:MALENOWSKI
Suffix:I
Gender:M
Credentials:PHARMD
Other - Prefix:
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Mailing Address - Street 1:9307 PEQUAYWAN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55803-9767
Mailing Address - Country:US
Mailing Address - Phone:218-848-8077
Mailing Address - Fax:218-727-4261
Practice Address - Street 1:1201 MILLER TRUNK HWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-5633
Practice Address - Country:US
Practice Address - Phone:218-727-8157
Practice Address - Fax:218-727-4261
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN1177401835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN900060700Medicaid