1932203940 NPI number — MR. THOMAS JOSEPH MALY LISW

Table of content: DR. PARAMJEET SABHARWAL M.D. (NPI 1871616037)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932203940 NPI number — MR. THOMAS JOSEPH MALY LISW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MALY
Provider First Name:
THOMAS
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LISW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932203940
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 25TH AVE SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALTOONA
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50009-1532
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-957-0185
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 30TH ST
Provider Second Line Business Practice Location Address:
VETERANS ADMINISTRATION MEDICAL CENTER
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50310-5774
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-699-5999
Provider Business Practice Location Address Fax Number:
515-699-5563
Provider Enumeration Date:
09/11/2006

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: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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