Individual
MARTY ELIJAH MALLOY-MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN, CRNA, CNP
Contact information
Practice address
1320 W MAIN ST, NEWARK, OH 43055-1822
(220) 564-4226
(220) 564-4226
Mailing address
658 STEWART AVE, COLUMBUS, OH 43206-2974
(740) 285-6529
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.382689
OH
163W00000X
Registered Nurse
RN382689
OH
363L00000X
Nurse Practitioner
APRN.CNP.0027784
OH
363LF0000X
Family Nurse Practitioner
APRN.CNP.0027784
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.019508
OH
367500000X
Certified Registered Nurse Anesthetist
APRNCRNA019508
OH
Other
Enumeration date
06/02/2017
Last updated
12/21/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us