Provider Demographics
NPI:1821303413
Name:MALIAKAL, THOMAS JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOSEPH
Last Name:MALIAKAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5261 HIGH VISTA DR
Mailing Address - Street 2:
Mailing Address - City:OREFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18069-9117
Mailing Address - Country:US
Mailing Address - Phone:201-661-0714
Mailing Address - Fax:
Practice Address - Street 1:CENTRA LYNCHBURG GENERAL HOSPITAL
Practice Address - Street 2:1901 TATE SPRINGS RD
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501
Practice Address - Country:US
Practice Address - Phone:201-661-0714
Practice Address - Fax:201-661-0714
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD451943207L00000X
VA0101271084207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology