Mallory Kathryn Joseph, MD
Dermatology, MOHS-Micrographic Surgery in Grandville, MI. Individual provider (NPI-1).
NPI number1306337399
StatusActive
Last updated in NPPESMay 19, 2025
Details
- NPI
- 1306337399
- Entity type
- Individual (NPI-1)
- Name
- Mallory Kathryn Joseph
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 24, 2018
- Certification date
- May 19, 2025
- Last updated
- May 19, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ND0101X | Dermatology, MOHS-Micrographic Surgery | 4301509122 | MI | Yes |
| 207N00000X | Dermatology | 4301509122 | MI |
Practice location
4285 Parkway Place Dr SwGrandville, MI 49418-2385
Phone 616-252-3376
Mailing address
4285 Parkway Place Dr SwGrandville, MI 49418-2385
Phone 616-252-3376
Other practice locations
4830 Becker Dr
Allendale, MI 49401-8616
Allendale, MI 49401-8616
Phone 616-252-3376
5900 Byron Center Ave Sw
Wyoming, MI 49519-9606
Wyoming, MI 49519-9606
Phone 616-252-3376
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