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Individual
HARVEY E MALLORY IV
Active
Individual
HARVEY E MALLORY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD2006-0166
NM
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD2006-0166
NM
Other
Enumeration date
08/20/2006
Last updated
07/26/2014
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