Individual
DR. JACOB MALLAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
33155 ANNAPOLIS ST, WAYNE, MI 48184-2405
(734) 467-4000
Mailing address
33155 ANNAPOLIS ST, WAYNE, MI 48184-2405
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5151016245
MI
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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