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Organization

JEFFERSON ASSOC IN INTERNAL MED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL I MALLINGER MD (MD OWNER OF CORP)
(412) 466-6161
Entity
Organization

Contact information

Practice address
575 COAL VALLEY RD, SUITE 405, CLAIRTON, PA 15025-3730
(412) 466-6161
(412) 466-0614
Mailing address
575 COAL VALLEY RD, SUITE 405, CLAIRTON, PA 15025-3730
(412) 466-6161
(412) 466-0614

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD016592E
PA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD016592E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0675793
PA
Enumeration date
09/21/2005
Last updated
07/12/2007
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