Provider Demographics
NPI:1972833705
Name:MALIN, THOMAS HERBERT (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:HERBERT
Last Name:MALIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MALLARD LANE
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1305
Mailing Address - Country:US
Mailing Address - Phone:717-737-3657
Mailing Address - Fax:717-737-1651
Practice Address - Street 1:5 MALLARD LANE
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-1305
Practice Address - Country:US
Practice Address - Phone:717-737-3657
Practice Address - Fax:717-737-1651
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-29
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD008780E207Q00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine