NPI 1598490013

Fanta Mallard, MEDICALASSISTANT

Practitioner Independent Medical Examiner Physician Gary, IN

Practice location

Address: 578 Tennessee St, Gary, IN 46402-1438
Phone: (312) 241-3044

Registered specialties (3)

Independent Medical Examiner Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 202C00000X Licence M6S9Q7R7 (IN)

Other Independent Medical Examiner providers in Indiana →

Ph.D. Medical Genetics

Other Service Providers Taxonomy 170100000X

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Driver

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1598490013
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Jul 2022
Record last updated: 19 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.