Dwight M Malone is a Driver based in Mesa, AZ. Dwight M Malone practices in Mesa, AZ. The NPI Number for Dwight M Malone is 1154774107 and holds a License No. L2088992 (Arizona).
The current practice location address for Dwight M Malone is 1505 N Country Club Dr Apt 118, Mesa, AZ and can be reached out via phone at 480-547-4960.
Location: 1505 N Country Club Dr Apt 118, Mesa, AZ, 85201-2518
Provider Profile Details
NPI Number
1154774107
Provider Name
Dwight M Malone
Credential
Provider Entity Type
Individual
Gender
Male
Address
1505 N Country Club Dr Apt 118, Mesa, AZ, 85201-2518
Phone Number
480-547-4960
Fax Number
Provider Enumeration Date
07/14/2016
Last Update Date
03/09/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 812493202 | 05 | AZ |
Provider Business Practice Location Address Details
Address
1505 N Country Club Dr Apt 118
City
State
Zip
85201-2518
Phone Number
480-547-4960
Fax Number
Provider Business Mailing Address Details
Address
1505 N Country Club Dr Apt 118
City
State
Zip
85201-2518
Phone Number
480-547-4960
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Driver
Speciality
-
Taxonomy
License No.
L2088992 (Arizona)
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
Badge
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