Individual
DR. PALEN POWELSON MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
49 JESSE HILL JR DR SE, ATLANTA, GA 30303-3049
(404) 778-1401
Mailing address
1850 BRIARVISTA WAY NE, ATLANTA, GA 30329-3642
(804) 357-0006
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5765
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2012
Last updated
05/13/2013
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