Individual provider · Type 1 NPI

Gary Michael Mallow

Student in an Organized Health Care Education/Training Program · Augusta, GA

NPI number 1659952323 Active

Practice location

1120 15th St
Augusta, GA 30912-0006

Call (954) 383-7454 Map

Mailing address

710 W 14th St Apt 317
Chicago, IL 60607-5101

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1659952323

Gary Michael Mallow's National Provider Identifier is 1659952323, issued on Apr 15, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Augusta, GA. The record was last updated on Apr 15, 2021.