1023570041 NPI number — MALCOLM NEHEMIAH PYLES MD

Table of content: STACY SCHMITZ (NPI 1073497566)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023570041 NPI number — MALCOLM NEHEMIAH PYLES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PYLES
Provider First Name:
MALCOLM
Provider Middle Name:
NEHEMIAH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PYLES
Provider Other First Name:
MALCOLM
Provider Other Middle Name:
NEHEMIAH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MALCOLM P CHELLIAH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1023570041
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/05/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2075 W 25TH ST APT 531
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44113-4151
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-571-0314
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 DANIEL BURNHAM CT STE 350C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94109-0464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-771-6300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/01/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  A189785 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)