Individual
MICHELE L MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5618 ODANA RD, MADISON, WI 53719-1208
(608) 274-1100
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
66768
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/09/2014
Last updated
01/05/2021
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