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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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 1558333492 NPPES
New York MEDICAID 00593242

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