Individual
MALLORY BROOKE O'NIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3901 BEAUBIEN ST STE 2102, DETROIT, MI 48201-2119
(313) 745-9048
(313) 993-3879
Mailing address
3901 BEAUBIEN ST STE 2102, DETROIT, MI 48201-2119
(313) 745-9048
(313) 993-3879
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
4301112964
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2011
Last updated
07/21/2022
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