Provider Demographics
NPI:1821210477
Name:J. MICHAEL MALONEY MD, PC
Entity Type:Organization
Organization Name:J. MICHAEL MALONEY MD, PC
Other - Org Name:CHERRY CREEK DERMATOLOGY, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-388-5629
Mailing Address - Street 1:3773 CHERRY CREEK NORTH DR
Mailing Address - Street 2:SUITE 970
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3804
Mailing Address - Country:US
Mailing Address - Phone:303-388-5629
Mailing Address - Fax:303-321-7586
Practice Address - Street 1:3773 CHERRY CREEK NORTH DR
Practice Address - Street 2:SUITE 970
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3804
Practice Address - Country:US
Practice Address - Phone:303-388-5629
Practice Address - Fax:303-321-7586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCM3608Medicare PIN