Provider Demographics
NPI:1881898518
Name:TONY M. MAALOUF, M.D.,P.C.
Entity type:Organization
Organization Name:TONY M. MAALOUF, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:MAURICE
Authorized Official - Last Name:MAALOUF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-283-1005
Mailing Address - Street 1:407 W JEFFERSON ST STE B
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-5485
Mailing Address - Country:US
Mailing Address - Phone:724-283-1005
Mailing Address - Fax:724-283-4612
Practice Address - Street 1:407 W JEFFERSON ST STE B
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5485
Practice Address - Country:US
Practice Address - Phone:724-283-1005
Practice Address - Fax:724-283-4612
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-14
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054326L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100052OtherBLACK LUNG
PAPO38742OtherCHAMPUS
PA1455350OtherBLUE CROSS BLUE SHIELD
PA0015480890002Medicaid
PA1493787OtherUNITED MINE WORKERS
PA3272431OtherAETNA
PA1500112OtherGATEWAY
PA5451223OtherUS HEALTHCARE PPO
PA0000785204OtherBLUE SHIELD INDIVIDUAL
PA140961OtherUNISON
PA2144417000OtherBLUE CROSS BLUE SHIELD IN
PA203064OtherHEALTH AMERICA ASSURANCE
PA0015480890002Medicaid
PA140961OtherUNISON
PA0015480890002Medicaid
PAPO38742OtherCHAMPUS
PA100052OtherBLACK LUNG
PA1493787OtherUNITED MINE WORKERS