Individual
HEIDI L MALLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
Mailing address
ESSENTIA HEALTH DULUTH CLINIC MCL2CRED, 400 EAST THIRD STREET, DULUTH, MN 55805-1951
(218) 786-3146
(218) 722-8792
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
26036
OK
207Q00000X
Family Medicine Physician
Primary
39579
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20013750A
—
OK
Enumeration date
03/09/2006
Last updated
03/17/2018
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