Provider Demographics
NPI:1760557169
Name:MALEY, MICHAEL W (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:MALEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 MARKET AVE N
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721-3127
Mailing Address - Country:US
Mailing Address - Phone:330-768-7737
Mailing Address - Fax:330-452-9636
Practice Address - Street 1:6310 MARKET AVE N
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44721-3127
Practice Address - Country:US
Practice Address - Phone:330-768-7737
Practice Address - Fax:330-494-8195
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1232111NS0005X
IL1232111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0639081Medicaid
OHT48477Medicare UPIN
OH0639081Medicaid