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1215356522
CHAITANYA MALLA
GRAND RAPIDS, MI
NPI
1215356522
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: MI 4301106032)
Enumeration Date
2014-04-15
Last Update Date
2017-09-18
Business Address
-- CHAITANYA MALLA MD
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503-2560
Phone number: 616-391-3139
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Mailing Address
-- CHAITANYA MALLA MD
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number:
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