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Individual
DR. MIDHUN MALLA
Active
Individual
DR. MIDHUN MALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R74151
AZ
207RH0003X
Hematology & Oncology Physician
32219
OK
207RH0003X
Hematology & Oncology Physician
Primary
46618
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R74151
TRAINING PERMIT
AZ
Enumeration date
08/16/2013
Last updated
08/29/2023
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