Individual
ALBERT K MALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 FRANKLIN ST, SUITE 230, JOHNSTOWN, PA 15905
(814) 262-7980
(814) 262-7983
Mailing address
1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
(814) 410-8300
(814) 410-8331
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD023412E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009992360011
—
PA
01
—
442753
BCBS
PA
01
—
P00940198
RAILROAD MEDICARE
—
Enumeration date
10/25/2005
Last updated
09/11/2012
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