Individual
FAITH MARIE MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
445 S KINGS DR, CHARLOTTE, NC 28204-3041
(980) 308-0141
(980) 308-0140
Mailing address
PO BOX 601843, CHARLOTTE, NC 28260-1843
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-09656
NC
363AM0700X
Medical Physician Assistant
—
CT
Other
Enumeration date
06/11/2016
Last updated
04/05/2022
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