Individual
DR. MIDHUN MALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 6TH AVE S, BIRMINGHAM, AL 35233-2110
(205) 934-9999
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R74151
AZ
207RH0003X
Hematology & Oncology Physician
32219
OK
207RH0003X
Hematology & Oncology Physician
Primary
46618
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R74151
TRAINING PERMIT
AZ
Enumeration date
08/16/2013
Last updated
08/29/2023
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