Organization
SUNIL MALHOTRA
Active
Other names
GOODMAN MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUNIL MALHOTRA M.D. (OWNER / PHYSICIAN)
(662) 536-3330
Entity
Organization
Contact information
Practice address
470 GOODMAN RD E, 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
207Q00000X
Family Medicine Physician
14652
MS
207R00000X
Internal Medicine Physician
Primary
14796
MS
213ES0103X
Foot & Ankle Surgery Podiatrist
80187
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117366
—
MS
Enumeration date
02/12/2010
Last updated
06/09/2014
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