Provider Demographics
NPI:1033325022
Name:ROLAND, MALCOLM M (MD)
Entity Type:Individual
Prefix:
First Name:MALCOLM
Middle Name:M
Last Name:ROLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2908 SOUTH LAMAR BLVD. SUITE 100
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-6902
Mailing Address - Country:US
Mailing Address - Phone:662-281-0112
Mailing Address - Fax:662-281-0943
Practice Address - Street 1:2908 SOUTH LAMAR BLVD. SUITE 100
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-6902
Practice Address - Country:US
Practice Address - Phone:662-281-0112
Practice Address - Fax:662-281-0943
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS193502084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine