Provider Demographics
NPI:1508209800
Name:MALIZIA, ROBERT ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANTHONY
Last Name:MALIZIA
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 1:2035 TECHNOLOGY PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-9422
Mailing Address - Country:US
Mailing Address - Phone:717-232-4567
Mailing Address - Fax:717-231-8152
Practice Address - Street 1:2035 TECHNOLOGY PKWY STE 201
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9422
Practice Address - Country:US
Practice Address - Phone:717-231-4567
Practice Address - Fax:717-231-8152
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD483865208600000X, 208C00000X
CAA173275208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery