Mallo, Charles J.
Mallo, Charles J. is an sole proprietor health care provider with primary practice located at 988 Oak Ridge Tpke Suite 350, Oak Ridge TN 37830-6930. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Mallo, Charles J. can be contacted via phone (865) 483-7030.Contact Information
Primary practice address
988 Oak Ridge Tpke Suite 350
Oak Ridge TN 37830-6930
Phone: (865) 483-7030
Fax: (865) 483-3954
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | 132331-1 | New York |
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 132331 | New York |
Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 132331 | New York |
Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 49148 | Tennessee |
Profile Details
NPI number | 1558333492 |
---|---|
LBN Legal business name | Mallo, Charles J. |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Feb 5th, 2006 |
Last updated | May 29th, 2014 - about 10 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1558333492 | NPPES |
New York | MEDICAID | 00593242 |
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