Mallory, Cheryl A

Mallory, Cheryl A is an individual health care provider with primary practice located at 2315 8Th St , Lewiston ID 83501-7301. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Mallory, Cheryl A can be contacted via phone (208) 746-1383.

Contact Information

Primary practice address
2315 8Th St Lewiston ID 83501-7301
Phone: (208) 746-1383
Fax: (208) 746-6348
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD000637598 Washington
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M-10915 Idaho

Profile Details

NPI number 1386677722
LBN Legal business name Mallory, Cheryl A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2006
Last updated Aug 18th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386677722 NPPES
Idaho Other 1386677722 REGENCE BLUESHIELD
Idaho MEDICAID 1386677722 REGENCE BLUESHIELD
Idaho MEDICAID 1009174 REGENCE BLUESHIELD
Idaho Other 177340 REGENCE BLUESHIELD
Idaho Other 307956 REGENCE BLUESHIELD

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