Individual
SAMANTHA L. MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1215 PLEASANT ST STE 514, DES MOINES, IA 50309-1418
(515) 241-8912
(515) 241-8988
Mailing address
1215 PLEASANT ST STE 514, DES MOINES, IA 50309-1418
(515) 241-8912
(515) 241-8988
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
27050
OK
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
MD-43466
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336375369
—
IA
Enumeration date
06/04/2009
Last updated
07/12/2016
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