Individual
MR. AVI MEIR SAMUEL MALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6644 EAST BAYWOOD AVENUE, BANNER BAYWOOD MEDICAL CENTER, MESA, AZ 85206
(480) 321-4740
(480) 321-4565
Mailing address
4838 E FLOWER ST, PHOENIX, AZ 85018-6538
(702) 845-1200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4512
AZ
Other
Enumeration date
09/25/2009
Last updated
01/13/2015
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