Individual
JUNG JIN EL-MALLAWANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12300 MCCRACKEN RD, GARFIELD HEIGHTS, OH 44125-2914
(216) 587-8334
(216) 587-8646
Mailing address
12300 MCCRACKEN RD, GARFIELD HEIGHTS, OH 44125-2914
(216) 587-8334
(216) 587-8646
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35.04.1711
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000216102
ANTHEM PIN NUMBER
OH
05
—
0600040
—
OH
01
—
350983
WELLCARE OF OHIO
OH
01
—
4007204
AETNA
OH
01
—
741167
BUCKEYE HEALTH PLAN
OH
01
—
T41711
SUMMACARE HEALTH PLAN
OH
Enumeration date
07/09/2006
Last updated
11/21/2011
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