Individual
REEMA MALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1040 EAGLE'S LANDING PARKWAY, SUITE 100, STOCKBRIDGE, GA 30281
(770) 474-7287
(770) 389-3713
Mailing address
1040 EAGLE'S LANDING PARKWAY, SUITE 100, STOCKBRIDGE, GA 30281
(770) 474-7287
(770) 389-3713
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
36039
AL
208600000X
Surgery Physician
60507
MN
208600000X
Surgery Physician
Primary
83461
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003227593A
—
GA
Enumeration date
09/28/2011
Last updated
08/06/2020
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