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Individual

SAMIR MALLAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
88 OSBORNE ST, JOHNSTOWN, PA 15905-4146
(814) 619-3373
Mailing address
88 OSBORNE ST, JOHNSTOWN, PA 15905-4146

Taxonomy

Speciality
Code
Description
License number
State
207RH0005X
Hypertension Specialist Physician
MD456497
PA
207RN0300X
Nephrology Physician
Primary
MD456497
PA

Other

Enumeration date
03/18/2019
Last updated
03/18/2019
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