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Organization

PAUL MALLAMO D.P.M. P C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL H MALLAMO (D.P.M. PC)
(586) 598-0455
Entity
Organization

Contact information

Practice address
52526 FORD LN, CHESTERFIELD, MI 48047-3514
(586) 598-0455
Mailing address
52526 FORD LN, CHESTERFIELD, MI 48047-3514

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901001813
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4253362
MI
01
480030776
RAILROAD MEDICARE
MI
Enumeration date
04/20/2007
Last updated
11/20/2007
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