Individual
DR. DAVID S. MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 12TH ST, MERIDIAN, MS 39301-4158
(601) 703-4276
(601) 703-6786
Mailing address
PO BOX 5183, MERIDIAN, MS 39302-5183
(601) 703-4282
(601) 703-4597
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
14346
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115840
—
MS
05
—
009903405
—
AL
01
—
140008165
RAILROAD MEDICARE
—
01
—
730-08815
BLUE CROSS OF AL
—
Enumeration date
11/16/2005
Last updated
11/07/2013
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