Individual
DR. STEPHEN JAMES MALLONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
134 MEDICAL PARK RD STE 100, MOORESVILLE, NC 28117-8527
(704) 662-0106
(808) 290-6369
Mailing address
PO BOX 1845, STATESVILLE, NC 28687-1845
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2015-01843
NC
208000000X
Pediatrics Physician
990
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4505
—
SC
Enumeration date
11/06/2006
Last updated
08/15/2023
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