Individual
DR. ERIC JOHN MALLICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1910 JAKE ALEXANDER BLVD W STE 201, SALISBURY, NC 28147-1165
(704) 638-8631
(704) 638-8639
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
116331
NC
208600000X
Surgery Physician
Primary
2008-01430
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1511E
BCBS
NC
05
—
5910179
—
NC
Enumeration date
03/01/2007
Last updated
11/28/2022
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