Provider Demographics
NPI:1467521740
Name:MALKIN, FRANK R (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:R
Last Name:MALKIN
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 1:67 UNION ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-7700
Mailing Address - Country:US
Mailing Address - Phone:508-650-9965
Mailing Address - Fax:508-655-0397
Practice Address - Street 1:67 UNION ST
Practice Address - Street 2:SUITE 105
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-7700
Practice Address - Country:US
Practice Address - Phone:508-650-9965
Practice Address - Fax:508-655-0397
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA59453207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FM3032221Medicaid
MAA66593Medicare UPIN
MAJ07209Medicare ID - Type Unspecified