Individual
DR. STEPHEN M MALOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2240 E CENTER ST, POCATELLO, ID 83201
(208) 233-8344
(208) 233-6983
Mailing address
2240 E CENTER ST, POCATELLO, ID 83201
(208) 233-8344
(208) 233-6983
Taxonomy
Speciality
Code
Description
License number
State
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
M3508
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010024275
REGENCE BLUE SHIELD OF ID
ID
05
—
003833100
—
ID
01
—
242157007
RAILROAD MEDICARE
ID
01
—
76814
BLUE CROSS OF ID
ID
Enumeration date
08/31/2006
Last updated
11/25/2013
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