Individual
RAYMUNDO T MALLARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
285 DIX LEEON DR, FAIRBURN, GA 30213-3609
(770) 461-5436
(770) 461-5436
Mailing address
285 DIX LEEON DR, FAIRBURN, GA 30213-3609
(770) 461-5436
(770) 461-5436
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
017855
GA
Other
Enumeration date
12/23/2006
Last updated
07/08/2007
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