Individual
MOUAZ H AL-MALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD # K14, DETROIT, MI 48202-2608
(313) 916-2871
Mailing address
10 CONNORS AVENUE, APT A-103, MANSFIELD, MA 02048
(313) 916-2871
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
228285
MA
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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