Provider Demographics
NPI:1962521344
Name:MALCAMPO, FRANCIS AGUSTIN (RPT)
Entity type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:AGUSTIN
Last Name:MALCAMPO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SUGARLOAF CT
Mailing Address - Street 2:APT. 202
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2300
Mailing Address - Country:US
Mailing Address - Phone:410-710-7812
Mailing Address - Fax:
Practice Address - Street 1:4730 ATRIUM CT
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3556
Practice Address - Country:US
Practice Address - Phone:410-998-8818
Practice Address - Fax:410-363-8795
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22154225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist