DR. FADI ELIAS MALAK (NPI# 1730275355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730275355 |
| Entity Type | Individual |
| Full Name | DR. FADI ELIAS MALAK |
| Credential | DPM |
| Practice Address |
913 Nw Garden Valley Blvd Roseburg OR 97470-6523 |
| Mailing Address |
Po Box 126 Winchester OR 97495-0126 |
| Practice Telephone | 5414401000 |
| Practice Fax Number | 5414401343 |
| Mailing Telephone | 5414401000 |
| Mailing Fax Number | 5414401343 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 00229 | OR | Podiatric Medicine & Surgery Service Providers |
| Street Address |
913 NW GARDEN VALLEY BLVD |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97470-6523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003874546 | Roseburg Vamc | Department of Veterans Affairs (VA) Pharmacy | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2006-05-03 |
| 1114525607 | Kenny Duong | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-10-15 |
| 1588262521 | Ayman Alholail | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-10-12 |
| 1194332528 | Carrie Webster | Psychologist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-09-29 |
| 1619580776 | Shane Gamble | Dietitian, Registered | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-08-28 |
| 1942811658 | Shannon O'leary | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-08-14 |
| 1215554209 | Joseph Albrecht | Dietitian, Registered | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-06-25 |
| 1609402601 | Crystal Marie Leatherman | Dietitian, Registered | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6513 | 2020-03-21 |
| 1477189710 | Foua Xiong | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2020-03-18 |
| 1700425741 | Leah Isip | Pharmacist | 913 Nw Garden Valley Blvd, Roseburg, OR 97471-6523 | 2019-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326547134 | Thoughtwork, LLC | Social Worker | 178 Nw Garden Valley Blvd, Roseburg, OR 97470 | 2018-02-07 |
| 1063932960 | Go Mo, LLC | Durable Medical Equipment & Medical Supplies | 627 Se Jackson St, Roseburg, OR 97470 | 2017-06-21 |
| 1497123335 | Brandi N Hamilton | Counselor | 215 S.e. Jackson, Roseburg, OR 97470 | 2015-09-09 |
| 1285031203 | Aric Fromdahl | Counselor | 215 Se Jackson, Roseburg, OR 97470 | 2014-11-20 |
| 1801292438 | Robin Knebel | Counselor | 215 Se Jackson St., Roseburg, OR 97470 | 2014-11-10 |
| 1700282415 | Samantha Marie Shelley | Counselor | 215 Se Jackson Street, Roseburg, OR 97470 | 2014-11-06 |
| 1043610660 | Cynthia Simmons | Counselor | 150 Ne Kenneth Ford Drive, Roseburg, OR 97470 | 2014-09-02 |
| 1083025431 | Toni Damewood Msn Pmhnp-bc | Nurse Practitioner | 770 Se Kane Street, Roseburg, OR 97470 | 2014-05-19 |
| 1801226196 | Denise Ingeman | Registered Nurse | 1548 South East Pine Street, Roseburg, OR 97470 | 2013-11-22 |
| 1356606909 | Carla Junette Rambel | Massage Therapist | 566 S.e. Jackson, Roseburg, OR 97470 | 2012-07-10 |
| Find all providers in zip 97470 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689677031 | Kash K. Siepert | Podiatrist | 2300 Nw Stewart Pkwy, Roseburg, OR 97471-1597 | 2005-05-31 |
| 1639614647 | G Jason Wilks Dpm PC | Podiatrist | 2564 Nw Edenbower Blvd, Ste 142, Roseburg, OR 97471-8854 | 2016-12-29 |
| 1720491046 | Nathaniel Keplinger | Podiatrist | 2300 Nw Stewart Pkwy, Roseburg, OR 97471-1597 | 2014-06-04 |
| 1851622153 | Roseburg Foot & Ankle Specialists, P.C. | Podiatrist | 2300 Nw Stewart Pkwy, Roseburg, OR 97471 | 2010-01-26 |
| 1316006539 | G Jason Wilks | Podiatrist | 2564 Nw Edenbower Blvd, Suite 142, Roseburg, OR 97471-8854 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154869659 | Mid-columbia Medical Center | Podiatrist | 33 Nichols Pkwy, Hood River, OR 97031-3121 | 2017-02-03 |
| 1033560867 | John M Barnes Dpm LLC | Podiatrist | 9615 Nw Randall Ln, Portland, OR 97229-5294 | 2016-06-22 |
| 1619338829 | Cara Beach | Podiatrist | 9900 Sw Hall Blvd Ste 100, Portland, OR 97223-5838 | 2016-03-15 |
| 1265743090 | Nanjin Jasmine Park | Podiatrist | 5311 Sw Baird St, Portland, OR 97219-5023 | 2010-06-26 |
| 1689991804 | Cassandra Bree Tomczak | Podiatrist | 19250 Sw 65th Ave Ste 200, Tualatin, OR 97062 | 2010-04-27 |
| 1326363839 | Kessa Mauras | Podiatrist | 1100 E. Marina Way, Suite 223, Hood River, OR 97031 | 2010-03-29 |
| 1598907537 | Joshua Johnson Boone | Podiatrist | 551 Lone Prine Blvd, The Dalles, OR 97058 | 2009-04-06 |
| 1699928168 | Kristy R Six | Podiatrist | 400 Sw Bluff Dr Ste 220, Bend, OR 97702-1697 | 2008-10-28 |
| 1306093265 | Gilbert Alan Hice | Podiatrist | 953 Foots Creek Road, Gold Hill, OR 97525 | 2008-08-22 |
| 1982870382 | Debra Kaye Lynch | Podiatrist | 4905 River Road N, Keizer, OR 97303 | 2008-05-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.