Individual
NADINE MALLAK
Active
Individual
NADINE MALLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
R 9633
IA
2085R0202X
Diagnostic Radiology Physician
Primary
MD181300
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982046868
INDIVIDUAL
—
Enumeration date
07/22/2013
Last updated
03/17/2018
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