Individual
MISS KELLY MICHELE MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DR, 1ST FLOOR TAUBMAN CTR RECP A, ANN ARBOR, MI 48109-5312
(734) 936-8051
Mailing address
3621 S STATE STREET, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301089143
MI
207Y00000X
Otolaryngology Physician
MD426319
PA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
4301089143
MI
Other
Enumeration date
02/28/2007
Last updated
08/31/2012
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