Malicki, Mark Mitchell
Malicki, Mark Mitchell is an individual health care provider with primary practice located at 322 Warren St Ste 300, Johnstown PA 15905-3443. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Malicki, Mark Mitchell can be contacted via phone (814) 288-1418.Contact Information
Primary practice address
322 Warren St Ste 300
Johnstown PA 15905-3443
Phone: (814) 288-1418
Fax: (814) 288-1525
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD069004L | Pennsylvania |
Profile Details
| NPI number | 1083619209 |
|---|---|
| LBN Legal business name | Malicki, Mark Mitchell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2005 |
| Last updated | Jun 17th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083619209 | NPPES |
| Pennsylvania | MEDICAID | 0017621130005 |
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