Provider Demographics
NPI:1134723331
Name:DOLTON, MALERIE (PHARMD)
Entity type:Individual
Prefix:
First Name:MALERIE
Middle Name:
Last Name:DOLTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MALERIE
Other - Middle Name:
Other - Last Name:PORTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:975 ROSTRAVER RD
Mailing Address - Street 2:
Mailing Address - City:ROSTRAVER TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15012-1946
Mailing Address - Country:US
Mailing Address - Phone:724-929-9155
Mailing Address - Fax:724-930-7916
Practice Address - Street 1:975 ROSTRAVER RD
Practice Address - Street 2:
Practice Address - City:ROSTRAVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15012-1946
Practice Address - Country:US
Practice Address - Phone:724-929-9155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP447514183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist