Individual
DR. NIRMALA MALLYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3001 S HANOVER ST, BALTIMORE, MD 21225-1233
(410) 350-3361
(410) 350-3474
Mailing address
3001 S HANOVER ST, BALTIMORE, MD 21225-1233
(410) 350-3361
(410) 350-3474
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
D18917
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IG03
MEDICARE GROUP NUMBER
MD
Enumeration date
11/08/2006
Last updated
10/31/2007
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