Nirmala Mallya, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

D18917 Issued in MD

Practice address

3001 S Hanover St
Baltimore, MD 21225-1233

Phone

(410) 350-3361

Fax

(410) 350-3474

NPI assigned

Nov 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baltimore Washington Pathology Group LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Baltimore, MD
  • NPI 1508844598
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1104996206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 S HANOVER ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212251233",
            "telephone_number": "410-350-3361",
            "fax_number": "410-350-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 S HANOVER ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212251233",
            "telephone_number": "410-350-3361",
            "fax_number": "410-350-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLYA",
        "first_name": "NIRMALA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MD",
            "license": "D18917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "IG03",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chris Gabriel Mallouh
• Rita Mallouh
• Jamie Adele Malloy
• Mai Ling Malloy, M.S., OTR/L
• Kiron Mallya, MD
• Sonal Mallya
• Peter Edward Malm, M.D.
• Ashlee Nicholle Malone, MD
• Celeste Monique Malone, PHD
• Debra L Malone, M.D.

• Anatomic Pathology & Clinical Pathology Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Anatomic Pathology & Clinical Pathology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.