Provider Demographics
NPI:1083705479
Name:MALONEY, NANCY J (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:J
Last Name:MALONEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 KIRKPATRICK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8148
Mailing Address - Country:US
Mailing Address - Phone:336-584-3100
Mailing Address - Fax:336-584-0696
Practice Address - Street 1:1041 KIRKPATRICK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8148
Practice Address - Country:US
Practice Address - Phone:336-584-3100
Practice Address - Fax:336-584-0696
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900924207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891256EMedicaid
NCG97953Medicare UPIN
NC891256EMedicaid