Jared Mallalieu, PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

H68311 Issued in MD

Legal business name

JARED MALLALIEU, PA

Practice address

484 Ritchie Hwy
Suite a
Severna Park, MD 21146-2961

Phone

(410) 544-4600

Fax

(410) 544-0997

NPI assigned

Jul 27, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jared Emerson Mallalieu, D.O.

Title

Owner/Director

Phone

(410) 544-4600

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439769600000",
    "number": "1053542985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10845 PHILADELPHIA RD",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211621717",
            "telephone_number": "410-335-0008",
            "fax_number": "410-335-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 RITCHIE HWY",
            "address_2": "SUITE A",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462961",
            "telephone_number": "410-544-4600",
            "fax_number": "410-544-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JARED MALLALIEU, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-27",
        "last_updated": "2015-08-17",
        "status": "A",
        "authorized_official_last_name": "MALLALIEU",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "EMERSON",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "410-544-4600",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MD",
            "license": "H68311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JHHC",
            "identifier": "242301",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "174406",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "D92MJE",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "U993",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheri Jacobs, LCPAT
• Stuart Jacobs, MD
• James E. Chappell, M.D., P.a.
• Janey, LLC
• Lori Elaine Janssen, MSW, LCSW
• Ayodeji C Jarrett, DDS
• Jeffrey C. Schmidlein, MD
• JLJ Medical Limited Liabilty Company, Priority Care Clinics
• John Burton Driscoll
• John E. Myhill, PH.D., P.a.

• Surgery Physician in Severna Park, MD
• Providers in Severna Park, MD by specialty
• Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.