Provider Demographics
NPI:1043035108
Name:MALPHRUS, DREW MCGUIRE
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:MCGUIRE
Last Name:MALPHRUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 MYRTLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GUYTON
Mailing Address - State:GA
Mailing Address - Zip Code:31312-6809
Mailing Address - Country:US
Mailing Address - Phone:912-547-1733
Mailing Address - Fax:
Practice Address - Street 1:108 MYRTLEWOOD DR
Practice Address - Street 2:
Practice Address - City:GUYTON
Practice Address - State:GA
Practice Address - Zip Code:31312-6809
Practice Address - Country:US
Practice Address - Phone:912-547-1733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant