Individual
DR. JOHN KENNETH MALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
32 STILES RD, STE 204, SALEM, NH 03079
(603) 894-9898
(603) 894-6270
Mailing address
32 STILES RD, STE 204, SALEM, NH 03079
(603) 894-9898
(603) 894-6270
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
10052
NH
208200000X
Plastic Surgery Physician
154434
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0103459Y0NH01
BC
NH
01
—
07571390
CIGNA
—
01
—
154434
TUFTS
—
01
—
21296
HARVARD
—
01
—
29841
FALLON
—
01
—
JIF258
BC
MA
Enumeration date
01/12/2006
Last updated
09/04/2012
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