Provider Demographics
NPI:1629041447
Name:MALLON, TIMOTHY M (MD, MPH, FACOEM)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:M
Last Name:MALLON
Suffix:
Gender:M
Credentials:MD, MPH, FACOEM
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:6508 FOLDED LEAF SQ
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-6061
Mailing Address - Country:US
Mailing Address - Phone:410-531-7914
Mailing Address - Fax:
Practice Address - Street 1:UNIFORMED SERVICES UNIVERSITY, DEPT OF PMB
Practice Address - Street 2:4301 JONES BRIDGE RD
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4712
Practice Address - Country:US
Practice Address - Phone:301-295-3718
Practice Address - Fax:301-295-0335
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA250585552083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine