Basic Information
Provider Information
NPI: 1215347562
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MALAVE SANCHEZ
FirstName: MELANIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 64442
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212644442
CountryCode: US
TelephoneNumber: 4103288040
FaxNumber: 4434623514
Practice Location
Address1: 827 LINDEN AVE
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212014606
CountryCode: US
TelephoneNumber: 4102258369
FaxNumber: 4435522685
Other Information
ProviderEnumerationDate: 05/07/2014
LastUpdateDate: 07/21/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/21/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200XD89069MDY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


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