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Individual

JESSIE E. MALLALIEU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C.

Contact information

Practice address
63 THOMAS JOHNSON DR, SUITE B, FREDERICK, MD 21702-4384
(301) 698-2424
Mailing address
63 THOMAS JOHNSON DR, SUITE B, FREDERICK, MD 21702-4384
(301) 698-2424

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C02972
MD

Other

Enumeration date
01/26/2007
Last updated
03/22/2013
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