Individual
WESLEY DANIEL MALLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(407) 595-2181
Mailing address
5213 S ALSTON AVE, DURHAM, NC 27713-4430
(919) 620-4855
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2021-00216
NC
208600000X
Surgery Physician
LL37661
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL37661
SC LICENSE
SC
Enumeration date
07/06/2015
Last updated
05/28/2021
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