Individual
MS. MALA T KAILASAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
333 COTTMAN AVE, FOX CHASE CANCER CENTER, PHILADELPHIA, PA 19111-2434
(215) 728-6900
(215) 214-1425
Mailing address
333 COTTMAN AVE, MEDICAL STAFF OFFICE, PHILADELPHIA, PA 19111-2434
(215) 728-6900
(215) 214-1425
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
434586
PA
208M00000X
Hospitalist Physician
434586
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022444470001
—
PA
Enumeration date
07/08/2006
Last updated
03/08/2011
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