Malta Medical Associates, Llc
May also be knows as Malta Medical Associates
Family Medicine Physician in Malta, MT(View on Map)
Legal Business Name
Malta Medical Associates, Llc
Also Known As
Malta Medical Associates
NPI Number
1528716370
NPI Type
Organization
Enumeration Date
03/11/2022
Specialties
(Taxonomies)Contact
Information
Purpose
Mailing
Location
Address
PO BOX 1235
830 SOUTH CENTRAL AVE
City
Malta
Malta
State
MT
MT
Postal Code
59538-1235
59538
Country
US
US
Telephone Number
(406) 654-2878
(406) 654-2878
Authorized Official
Name
Dr. Edwin Medina
Title or Position
PRESIDENT/CHIEF MEDICAL OFFICER
Telephone Number
(406) 654-2878
Identifiers
Identifier
0000922611
G414566
0720001
0028223
Identifier State
MT
MT
MT
MT
Identifier Issuer
BLUE CROSS BLUE SHIELD
Unknown
Unknown
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 02/07/2023