Organization

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)

Code

207Q00000X

Primary Taxonomy

Yes

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

Provider Address