Provider Demographics
NPI:1952419061
Name:MALAMED, MELISSA KIM (DPM)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:KIM
Last Name:MALAMED
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 HORIZON DR
Mailing Address - Street 2:STE 106
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914
Mailing Address - Country:US
Mailing Address - Phone:215-997-3668
Mailing Address - Fax:215-997-0992
Practice Address - Street 1:1500 HORIZON DR
Practice Address - Street 2:STE 106
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914
Practice Address - Country:US
Practice Address - Phone:215-997-3668
Practice Address - Fax:215-997-0992
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004488L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U72176Medicare UPIN
018413PVUMedicare ID - Type Unspecified