Individual
THOMAS G. MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 E 3RD ST, ESSENTIA HEALTH DULUTH CLINIC, DULUTH, MN 55805-1951
(218) 786-8364
(218) 786-8364
Mailing address
400 E 3RD ST, ESSENTIA HEALTH DULUTH CLINIC, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
107458
MN
207RG0100X
Gastroenterology Physician
31007
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31598000
—
WI
01
—
P00700736
RR MEDICARE
WI
Enumeration date
04/05/2006
Last updated
05/06/2014
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