Provider Demographics
NPI:1811093198
Name:MALVEY, TODD CHRISTOPHER (DO)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:CHRISTOPHER
Last Name:MALVEY
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1 E MAIN ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1662
Mailing Address - Country:US
Mailing Address - Phone:508-393-0183
Mailing Address - Fax:508-393-2310
Practice Address - Street 1:1 E MAIN ST
Practice Address - Street 2:SUITE 208
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1662
Practice Address - Country:US
Practice Address - Phone:508-393-0183
Practice Address - Fax:508-393-2310
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2011-10-12
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Provider Licenses
StateLicense IDTaxonomies
SC836207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCVAD 000Medicare UPIN