Fanta Mallard, MEDICALASSISTANT
Fanta Mallard, MEDICALASSISTANT is a Ph.D. Medical Genetics in Gary, Indiana. Practices as a sole proprietor. Licensed in Indiana.
- Licensed in
- IN
- In the registry since
- 2022
- Specialties on file
- 3
Practice location Address checks out
578 Tennessee StGary, IN 46402-1438
Phone: (312) 241-3044
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Independent Medical Examiner Physician (primary) | Taxonomy 202C00000X · Licence M6S9Q7R7 (IN) |
|---|---|
| Ph.D. Medical Genetics | Taxonomy 170100000X |
| Driver | Taxonomy 172A00000X |
Record details
| NPI number | 1598490013 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | MEDICALASSISTANT |
| Sole proprietor | Yes |
| NPI enumerated | July 19, 2022 |
| Last updated in NPPES | July 19, 2022 |
| Certification date | July 19, 2022 |