| Doctor Name: | DR. FREDRIC A MALMBERG |
| NPI Number: | 1003966078 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | SC002338L |
| Business Practice Address: | 1720 S Queen St Suite 130 York, PA - 174034632 |
| Business Phone Number: | 7178482750 |
| Business Fax Number: | |
| Mailing Address: | 1720 S Queen St, Suite 130 YORK |
| State: | PA |
| Postal Code: | 174034632 |
| Phone Number: | 7178482750 |
| Fax Number: | |
| NPI Enumeration Date: | 01/11/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | SC002338L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |