Individual
BRANDERLY MALIWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3311 HIGHWAY 5 STE C, DOUGLASVILLE, GA 30135-2375
(678) 383-6944
Mailing address
3311 HIGHWAY 5, SUITE C, ONE STOP MEDICAL CLINIC, DOUGLASVILLE, GA 30135
(765) 326-0148
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN224384
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447790530
—
GA
Enumeration date
03/08/2017
Last updated
06/16/2018
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