Fanta Mallard, MEDICAL ASSISTANT

NPI #1598490013 in Gary, Indiana

Provider Information

NPI Number
1598490013
Entity Type
Individual
Name
Fanta Mallard, MEDICAL ASSISTANT
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Independent Medical Examiner
Credential
MEDICAL ASSISTANT
Enumeration Date
Jul 19, 2022
Last Updated
Jul 19, 2022

Practice Location

Address
578 TENNESSEE ST
City
Gary
State
Indiana
ZIP Code
46402-1438
Phone
(312) 241-3044

Specialties & Taxonomy Codes

Specialty
Medical Genetics, Ph.D. Medical Genetics
Driver
Independent Medical Examiner

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