Provider Demographics
NPI:1598739039
Name:MALAMENT, IRWIN BERNARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:BERNARD
Last Name:MALAMENT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3410 N HIGH SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-1100
Mailing Address - Country:US
Mailing Address - Phone:317-299-2644
Mailing Address - Fax:317-328-8914
Practice Address - Street 1:3410 N HIGH SCHOOL RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-1742
Practice Address - Country:US
Practice Address - Phone:317-299-2644
Practice Address - Fax:317-328-8914
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN7000441213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100319520AMedicaid
IN100319520AMedicaid
IN0434370001Medicare NSC