DR. Charles J. Mallo, M.D.

NPI #1558333492 in Oak Ridge, Tennessee

Provider Information

NPI Number: 1558333492
Entity Type: Individual
Name: DR. Charles J. Mallo, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: M.D.
Enumeration Date: Feb 5, 2006
Last Updated: May 29, 2014

Practice Location

Address: 988 OAK RIDGE TPKE
Address 2: SUITE 350
City: Oak Ridge
State: Tennessee
ZIP Code: 37830-6930
Phone: (865) 483-7030

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary
Surgery	208600000X
Surgery - Vascular Surgery — Vascular Surgery	2086S0129X

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