Individual
SUNIL MALHOTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
470 GOODMAN ROAD, SOUTHAVEN, MS 38671-9557
(662) 536-3330
(662) 536-3329
Mailing address
470 GOODMAN RD E, SOUTHAVEN, MS 38671-9557
(662) 536-3330
(662) 536-3329
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14796
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117366
—
MS
Enumeration date
11/06/2006
Last updated
03/15/2022
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