Individual
FANTA MALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MEDICAL ASSISTANT
Contact information
Practice address
578 TENNESSEE ST, GARY, IN 46402-1438
(312) 241-3044
Mailing address
578 TENNESSEE ST, GARY, IN 46402-1438
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
—
—
172A00000X
Driver
—
—
202C00000X
Independent Medical Examiner Physician
Primary
M6S9Q7R7
IN
Other
Enumeration date
07/19/2022
Last updated
07/19/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us