NPI 1154774107

Dwight M Malone

Practitioner Driver Mesa, AZ

Practice location

Address: 1505 N Country Club Dr APT 118, Mesa, AZ 85201-2518
Phone: (480) 547-4960

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence L2088992 (AZ)

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Registry record

NPI: 1154774107
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Jul 2016
Record last updated: 14 Jul 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.