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1013949668
GIRIDHAR MALLYA
PHILADELPHIA, PA
NPI
1013949668
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: PA MD427990)
Enumeration Date
2006-07-06
Last Update Date
2011-03-10
Business Address
-- GIRIDHAR MALLYA MD
51 N 39TH ST
PHILADELPHIA, PA 19104-2640
Phone number: 215-662-8777
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Mailing Address
-- GIRIDHAR MALLYA MD
51 N 39TH ST
PHILADELPHIA, PA 19104-2640
Phone number: 215-662-8777
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