Provider Demographics
NPI:1629776877
Name:ARNOLD, MALCOLM CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:MALCOLM
Middle Name:CHRISTOPHER
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 HINTON RD
Mailing Address - Street 2:
Mailing Address - City:SHADY SPRING
Mailing Address - State:WV
Mailing Address - Zip Code:25918-8409
Mailing Address - Country:US
Mailing Address - Phone:304-573-9492
Mailing Address - Fax:
Practice Address - Street 1:423 HINTON RD
Practice Address - Street 2:
Practice Address - City:SHADY SPRING
Practice Address - State:WV
Practice Address - Zip Code:25918-8409
Practice Address - Country:US
Practice Address - Phone:304-573-9492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant