Dr Stephen James Malloney, DO | |
134 Medical Park Rd Ste 100, Mooresville, NC 28117-8527 | |
(704) 662-0106 | |
(808) 290-6369 |
Full Name | Dr Stephen James Malloney |
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Gender | Male |
Speciality | Pediatrics |
Location | 134 Medical Park Rd Ste 100, Mooresville, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083783245 | NPI | - | NPPES |
GP4505 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 990 (South Carolina) | Secondary |
208000000X | Pediatrics | 2015-01843 (North Carolina) | Primary |
Entity Name | Piedmont Healthcare Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912999897 PECOS PAC ID: 9638070683 Enrollment ID: O20040114000339 |
Mailing Address | Practice Location Address |
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Dr Stephen James Malloney, DO Po Box 1845, Statesville, NC 28687-1845 Ph: () - | Dr Stephen James Malloney, DO 134 Medical Park Rd Ste 100, Mooresville, NC 28117-8527 Ph: (704) 662-0106 |
Laura Therese Recchi, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 136 Gateway Blvd Ste A, Mooresville, NC 28117 Phone: 704-799-2878 Fax: 704-799-1627 | |
Elizabeth Ellen Tilt, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 511 Lisa Carol Dr, Mooresville, NC 28115 Phone: 704-651-3907 | |
Gianna Demos Madrid, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 656 Carpenter Ave, Mooresville, NC 28115 Phone: 704-664-5133 Fax: 704-799-6356 | |
Shelley H. Rinker, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 133 Welton Way, Suite C, Mooresville, NC 28117 Phone: 704-664-2552 Fax: 704-664-5382 | |
Lisa Schroepfer Thomas, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 136 Gateway Blvd Ste A, Mooresville, NC 28117 Phone: 704-799-2878 Fax: 704-799-1627 | |
Amy Poteat Ferguson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 656 Carpenter Ave, Mooresville, NC 28115 Phone: 704-664-5133 |