Mall, Gary Michael

Mall, Gary Michael is an individual health care provider with primary practice located at 15790 Paul Vega Md Dr , Hammond LA 70403-1434. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Mall, Gary Michael can be contacted via phone (985) 230-1362.

Contact Information

Primary practice address
15790 Paul Vega Md Dr Hammond LA 70403-1434
Phone: (985) 230-1362
Fax: (985) 230-1617
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD.019924 Louisiana

Profile Details

NPI number 1568491330
LBN Legal business name Mall, Gary Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2006
Last updated Dec 10th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568491330 NPPES
Louisiana MEDICAID 1396087
Louisiana MEDICAID 04523891
Louisiana Other 930094372

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