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Individual

WILLIAM MALLIN

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-5339
Mailing address
3601 W 13 MILE RD, 400-FSC/PCS, ROYAL OAK, MI 48073-6712

Taxonomy

Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
4301079473
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4396015
MI
Enumeration date
03/23/2006
Last updated
07/08/2007
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