Individual
DR. STEPHEN GUY MALLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
707 US HIGHWAY 31 S, SUITE F, ATHENS, AL 35611-3619
(256) 771-1995
(256) 771-1965
Mailing address
707 US HIGHWAY 31 S, SUITE F, ATHENS, AL 35611-3619
(259) 771-1995
(256) 771-1965
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
DO-841
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51522611
BLUE CROSS BLUE SHIELD AL
AL
Enumeration date
04/11/2006
Last updated
03/03/2008
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