Martin, Terence Malloy

Martin, Terence Malloy is an individual health care provider with primary practice located at 1600 Forsyth St , Macon GA 31201-1408. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Martin, Terence Malloy can be contacted via phone (478) 743-3000.

Contact Information

Primary practice address
1600 Forsyth St Macon GA 31201-1408
Phone: (478) 743-3000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 000239 Georgia

Profile Details

NPI number 1578616868
LBN Legal business name Martin, Terence Malloy
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2007
Last updated Sep 15th, 2015 - about 11 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 1578616868 NPPES
Georgia MEDICAID 100002814A

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