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Individual

JAMES S MALLERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6500 EXCELSIOR BLVD SUITE 4-820, DIGESTIVE AND ENDOSCOPY CENTER METHODIST HOSPITAL, ST LOUIS PARK, MN 55426
(952) 993-3240
(952) 993-2640
Mailing address
6500 EXCELSIOR BLVD SUITE 4-820, DIGESTIVE AND ENDOSCOPY CENTER METHODIST HOSPITAL, ST LOUIS PARK, MN 55426
(952) 993-3240
(952) 993-2640

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
36617
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
834323300
MN
Enumeration date
06/08/2006
Last updated
11/07/2012
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