Individual
DR. MALLIKARJUN PATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12750 SAINT FRANCIS DR, CROWN POINT, IN 46307-0264
(219) 852-1524
(219) 933-2288
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01057540A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200428170A
—
IN
Enumeration date
03/03/2006
Last updated
07/03/2025
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