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Individual

VENKATA C MALLU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
707 N HOUSTON RD, WARNER ROBINS, GA 31093-2101
(478) 922-4010
Mailing address
101 ROYAL CREST CIR, KATHLEEN, GA 31047-2144
(478) 319-5962
(478) 745-8932

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
062252
GA
208M00000X
Hospitalist Physician
062252
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
586433793
GA
Enumeration date
12/27/2007
Last updated
09/08/2025
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