Individual
DR. PAVAN S MALLUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 FRANCIS ST, SUITE 6E, BOSTON, MA 02215-5501
(617) 632-7509
Mailing address
110 FRANCIS ST, SUITE 6E, BOSTON, MA 02215-5501
(617) 632-7509
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
247305
MA
Other
Enumeration date
06/29/2007
Last updated
07/07/2011
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