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Organization
PAUL MALLAMO D.P.M. P C
Active
Organization
PAUL MALLAMO D.P.M. P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL H MALLAMO (D.P.M. PC)
(586) 598-0455
Entity
Organization
Contact information
Practice address
52526 FORD LN, CHESTERFIELD, MI 48047-3514
(586) 598-0455
Mailing address
52526 FORD LN, CHESTERFIELD, MI 48047-3514
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901001813
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4253362
—
MI
01
—
480030776
RAILROAD MEDICARE
MI
Enumeration date
04/20/2007
Last updated
11/20/2007
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