Doctor Name: | KIRON MALLYA |
NPI Number: | 1023277670 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | |
Business Practice Address: | 22 S Greene St Pediatrics, N5w56 Baltimore, MD - 212011544 |
Business Phone Number: | 4103286662 |
Business Fax Number: | 4103280646 |
Mailing Address: | Po Box 62063, BALTIMORE |
State: | MD |
Postal Code: | 212642063 |
Phone Number: | 4107065181 |
Fax Number: | 4107065103 |
NPI Enumeration Date: | 06/07/2008 |
NPI Last Update Date: | 08/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |