Individual
ALAN H MALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18444 N 25TH AVE, STE 310, PHOENIX, AZ 85023-1266
(866) 974-2673
(866) 939-2673
Mailing address
10474 W THUNDERBIRD BLVD, SUITE 200, SUN CITY, AZ 85351-3015
(866) 974-2673
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
9569
AZ
207R00000X
Internal Medicine Physician
9569
AZ
207RR0500X
Rheumatology Physician
Primary
09569
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246042
—
AZ
Enumeration date
01/23/2006
Last updated
10/06/2014
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