Individual
SANFORD R. MALLIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
788 N JEFFERSON ST, SUITE 300, MILWAUKEE, WI 53202-3718
(414) 272-8950
(414) 272-0859
Mailing address
788 N JEFFERSON ST, SUITE 300, MILWAUKEE, WI 53202-3718
(414) 272-8950
(414) 272-0859
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
13078
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30915100
—
WI
Enumeration date
06/08/2006
Last updated
07/08/2007
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