Provider Demographics
NPI:1730170499
Name:MALAS, AMER (MD)
Entity type:Individual
Prefix:
First Name:AMER
Middle Name:
Last Name:MALAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 JAMESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-1975
Mailing Address - Country:US
Mailing Address - Phone:304-342-9012
Mailing Address - Fax:
Practice Address - Street 1:9 JAMESTOWN RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314-1975
Practice Address - Country:US
Practice Address - Phone:304-342-9012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18266207R00000X
TXP7948207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0078397000Medicaid
TX335409401Medicaid
WV07278616800OtherOHIO BWC
WV2154761OtherOHIO JOB & FAMILY
WV4055327Medicare PIN
TX350375YK00Medicare PIN
WVG16840Medicare UPIN
WVG16840Medicare UPIN