Provider Demographics
NPI:1477304939
Name:MALKOV, DENIS YEVGENYEVICH (DO, MD)
Entity Type:Individual
Prefix:DR
First Name:DENIS
Middle Name:YEVGENYEVICH
Last Name:MALKOV
Suffix:
Gender:M
Credentials:DO, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CHELSEA LN
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1010
Mailing Address - Country:US
Mailing Address - Phone:847-924-0518
Mailing Address - Fax:
Practice Address - Street 1:1900 10TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3601
Practice Address - Country:US
Practice Address - Phone:706-571-1430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program