Individual
MICHAEL MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
1001 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1605
(404) 250-2972
Mailing address
2133 KODIAK DR NE, ATLANTA, GA 30345-4149
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
046445
GA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
4928357-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497037753
—
GA
Enumeration date
04/14/2006
Last updated
01/30/2024
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