Provider Demographics
NPI:1841482395
Name:IZOLD A MALAMENT MD INC
Entity type:Organization
Organization Name:IZOLD A MALAMENT MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IZOLD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALAMENT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-975-1190
Mailing Address - Street 1:36001 EUCLID AVE STE B12
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4643
Mailing Address - Country:US
Mailing Address - Phone:614-430-5724
Mailing Address - Fax:614-430-5742
Practice Address - Street 1:36001 EUCLID AVE STE B12
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4643
Practice Address - Country:US
Practice Address - Phone:440-975-1190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty