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NPI 1154774107

IndividualActive

Dwight Malone

NPI 1154774107 · Driver · Mesa, AZ

Provider details

NPI number: 1154774107
Entity type: Individual
Primary specialty: DriverOther Service Providers
Sex: Male
Sole proprietor: No
License: L2088992 (AZ)

Practice location

1505 N Country Club Dr Apt 118

Mesa, AZ 85201-2518

Phone: (480) 547-4960

More AZ providers

Mailing address

1505 N Country Club Dr Apt 118

Mesa, AZ 85201-2518

Registry dates

Enumerated: 2016-07-14
Last updated: 2016-07-14

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Dwight Malone — NPI 1154774107, Mesa, AZ | NPI Central