Provider Demographics
NPI:1275579468
Name:MALAMED, DAVID H (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:H
Last Name:MALAMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 NUTT RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-3906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 NUTT ROAD
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460
Practice Address - Country:US
Practice Address - Phone:610-983-1100
Practice Address - Fax:610-983-1138
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043029L2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00141768600004Medicaid
F37847Medicare UPIN
PA00141768600004Medicaid