Provider Demographics
NPI:1134577455
Name:ALAN R MALOUF MD PA
Entity type:Organization
Organization Name:ALAN R MALOUF MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:MALOUF
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:301-805-9200
Mailing Address - Street 1:17000 SCIENCE DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4420
Mailing Address - Country:US
Mailing Address - Phone:301-805-9200
Mailing Address - Fax:301-805-9632
Practice Address - Street 1:17000 SCIENCE DR
Practice Address - Street 2:SUITE 108
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4420
Practice Address - Country:US
Practice Address - Phone:301-805-9200
Practice Address - Fax:301-805-9632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0034462207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty