Provider Demographics
NPI:1730156597
Name:MALCHEFF, TIMOTHY MICHAEL (DC)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:MICHAEL
Last Name:MALCHEFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 OLDS ST
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49250-9477
Mailing Address - Country:US
Mailing Address - Phone:517-849-0000
Mailing Address - Fax:517-849-2631
Practice Address - Street 1:735 OLDS ST
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:MI
Practice Address - Zip Code:49250-9477
Practice Address - Country:US
Practice Address - Phone:517-849-0000
Practice Address - Fax:517-849-2631
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950C06053OtherBCBS
MI1626686Medicaid
MI950C06053OtherBCBS
MI1626686Medicaid