Jared Mallalieu, PA

NPI #1053542985 in Severna Park, Maryland

Provider Information

NPI Number: 1053542985
Entity Type: Organization
Organization Name: Jared Mallalieu, PA
Primary Specialty: Surgery
Enumeration Date: Jul 27, 2009
Last Updated: Aug 17, 2015

Practice Location

Address: 484 RITCHIE HWY
Address 2: SUITE A
City: Severna Park
State: Maryland
ZIP Code: 21146-2961
Phone: (410) 544-4600

Authorized Official

Name: JARED EMERSON MALLALIEU, D.O.
Title: OWNER/DIRECTOR
Phone: (410) 544-4600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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