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Individual

DR. JULIUS Q MALLETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
324 N QUEEN STREET, KINSTON, NC 28501-4932
(252) 522-9800
(252) 523-9790
Mailing address
120 W MARTIN LUTHER KING JR DR, WASHINGTON, NC 27889-4906
(252) 940-0602
(252) 940-0924

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
28261
NC
207VM0101X
Maternal & Fetal Medicine Physician
28261
NC
207VX0000X
Obstetrics Physician
28261
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
160034966
RAILROAD MEDICARE
NC
01
2170961
MEDICARE
NC
01
53777
BCBS NC
NC
05
8953777
NC
Enumeration date
08/25/2005
Last updated
12/05/2024
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