Active NPI
David Michael Malenowski I, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Duluth, MN
National Provider Identifier
1023393220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 117740
- Practice address
- 1201 Miller Trunk Hwy
Duluth, MN 55811-5633 - Phone
- (218) 727-8157
- Fax
- (218) 727-4261
- NPI assigned
- Oct 19, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 117740 | MN | Primary |
Addresses
Primary practice location
1201 Miller Trunk Hwy
Duluth, MN 55811-5633
Mailing address
9307 Pequaywan Lake Rd
Duluth, MN 55803-9767
Phone (218) 848-8077
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 900060700 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117740 | MN | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318982400000",
"number": "1023393220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9307 PEQUAYWAN LAKE RD",
"city": "DULUTH",
"state": "MN",
"postal_code": "558039767",
"telephone_number": "218-848-8077",
"fax_number": "218-727-4261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 MILLER TRUNK HWY",
"city": "DULUTH",
"state": "MN",
"postal_code": "558115633",
"telephone_number": "218-727-8157",
"fax_number": "218-727-4261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALENOWSKI",
"first_name": "DAVID",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"name_suffix": "I",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-19",
"last_updated": "2011-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MN",
"license": "117740",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "900060700",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.