Mallu, Venkata C

Mallu, Venkata C is an individual health care provider with primary practice located at 777 Hemlock St , Macon GA 31201-2102. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Mallu, Venkata C can be contacted via phone (478) 741-7241.

Contact Information

Primary practice address
777 Hemlock St Macon GA 31201-2102
Phone: (478) 741-7241
Fax: (478) 745-8932
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 062252 Georgia
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 062252 Georgia

Profile Details

NPI number 1598949547
LBN Legal business name Mallu, Venkata C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2007
Last updated Jan 11th, 2023 - about 2 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 1598949547 NPPES
Georgia MEDICAID 586433793

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