Most Relevant Information
Provider Data
| NPI Number: | 1003486663 |
| Provider Name: | COLIN MALCOLM |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 0110008132 |
Most Important Dates
| Enumeration Date: | 06/28/2021 |
| Last Updated: | 10/14/2021 |
Provider Practice Location
125 NATIONWIDE DR
LYNCHBURG
VA
245024272
Practice Location Phone/Fax
| Phone: | 4342003908 |
| Fax: |
Provider Mailing Location
125 NATIONWIDE DR
LYNCHBURG
VA
245024272
Provider Mailing Phone/Fax
| Phone: | 4342003908 |
| Fax: |