Provider Demographics
NPI:1487616876
Name:MALACHOWSKY, RON STEWART (PA)
Entity type:Individual
Prefix:MR
First Name:RON
Middle Name:STEWART
Last Name:MALACHOWSKY
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:1970 ROANOKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-6404
Mailing Address - Country:US
Mailing Address - Phone:540-982-2463
Mailing Address - Fax:540-224-1969
Practice Address - Street 1:1970 ROANOKE BLVD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-6404
Practice Address - Country:US
Practice Address - Phone:540-982-2463
Practice Address - Fax:540-224-1969
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2012-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110-001471363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical