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Individual

DR. STEPHEN DONALD MALLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1400 6TH AVE S, BIRMINGHAM, AL 35233-1502
(205) 930-1501
(205) 930-0243
Mailing address
1400 6TH AVE S, BIRMINGHAM, AL 35233-1502
(205) 930-1501
(205) 930-0243

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
00019373
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051032090
BLUE SHIELD OF ALABAMA
AL
01
051032095
BLUE SHIELD OF ALABAMA
AL
01
051513704
BLUE SHIELD OF ALABAMA
AL
01
051513705
BLUE SHIELD OF ALABAMA
AL
01
051516185
BLUE SHIELD OF ALABAMA
AL
01
051520380
BLUE SHIELD OF ALABAMA
AL
01
051528591
BLUE SHIELD OF ALABAMA
AL
05
303700331
AL
05
303710331
AL
05
303720331
AL
05
303730331
AL
05
303740331
AL
05
303760331
AL
05
303790331
AL
Enumeration date
02/02/2006
Last updated
02/18/2011
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