Provider Demographics
NPI:1083620504
Name:MALAVE, HECTOR A (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:A
Last Name:MALAVE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:755 MOUNT VERNON HWY
Mailing Address - Street 2:530
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4274
Mailing Address - Country:US
Mailing Address - Phone:404-252-7970
Mailing Address - Fax:404-250-0553
Practice Address - Street 1:755 MOUNT VERNON HWY NE
Practice Address - Street 2:530
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4274
Practice Address - Country:US
Practice Address - Phone:404-252-7970
Practice Address - Fax:404-252-0553
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2012-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA54401207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA660196452 A, B, CMedicaid
GA660196452 A, B, CMedicaid
GAH80138Medicare UPIN