Provider Demographics
NPI:1275525859
Name:MALOUF, ALAN ROY (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ROY
Last Name:MALOUF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:17000 SCIENCE DR
Mailing Address - Street 2:STE 108
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4431
Mailing Address - Country:US
Mailing Address - Phone:301-805-9200
Mailing Address - Fax:301-805-9632
Practice Address - Street 1:17000 SCIENCE DR STE 108
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4431
Practice Address - Country:US
Practice Address - Phone:301-805-9200
Practice Address - Fax:301-805-9632
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0034462207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC22940002OtherBCBS DC INDIVIDUAL ID#
MD20432OtherMAMSI INDIVIDUAL ID#
MD40301606OtherBCBS MD INDIVIDUAL ID#
MD465210OtherAETNA INDIVIDUAL ID#
MD776378OtherUNITED HEALTHCARE ID#
MDKW77GEOtherBCBS MD GROUP ID#
MD180023952OtherRAILROAD MEDICARE ID#
MD492828OtherHEALTHLINK/NCPPO ID#
MD180023952OtherRAILROAD MEDICARE ID#
MDKW77GEOtherBCBS MD GROUP ID#
MD20432OtherMAMSI INDIVIDUAL ID#
MDE69215Medicare UPIN
MD984031101Medicaid