Provider Demographics
NPI:1316202575
Name:MALLAY, SETH N J (DO)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:N J
Last Name:MALLAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:505 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1266
Mailing Address - Country:US
Mailing Address - Phone:517-748-5500
Mailing Address - Fax:517-783-2728
Practice Address - Street 1:240 W CARLETON RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-5034
Practice Address - Country:US
Practice Address - Phone:517-212-8140
Practice Address - Fax:517-212-8141
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2015-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101019724207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine