Provider Demographics
NPI:1720353881
Name:MALMAD, JESSICA LAINE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LAINE
Last Name:MALMAD
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Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:5462 MEMORIAL DR STE 202
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-3239
Mailing Address - Country:US
Mailing Address - Phone:404-292-5676
Mailing Address - Fax:404-299-8657
Practice Address - Street 1:5462 MEMORIAL DR STE 202
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3239
Practice Address - Country:US
Practice Address - Phone:404-292-5676
Practice Address - Fax:404-299-8657
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2016-06-27
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Provider Licenses
StateLicense IDTaxonomies
GA074052207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine