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Organization

STEPHEN M MALOFF MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHEN M MALOFF MD (PHYSICIAN)
(208) 232-5550
Entity
Organization

Contact information

Practice address
1950 E CLARK STREET, SUITE A, POCATELLO, ID 83205
(208) 232-5550
(208) 232-5553
Mailing address
PO BOX 4948, 1950 E CLARK STREET SUITE A, POCATELLO, ID 83205
(208) 232-5550
(208) 232-5553

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
05
D03833100
ID
Enumeration date
07/03/2007
Last updated
08/22/2020
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