Provider Demographics
NPI:1295845535
Name:MALLARI, MARGARET Q (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:Q
Last Name:MALLARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03570-2084
Mailing Address - Country:US
Mailing Address - Phone:603-752-3669
Mailing Address - Fax:603-752-3027
Practice Address - Street 1:133 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NH
Practice Address - Zip Code:03570-2006
Practice Address - Country:US
Practice Address - Phone:603-752-2040
Practice Address - Fax:603-752-7797
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH127409207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH12749OtherNH LICENSE
NH792609OtherMVP HEALTH CARE
NH01YP08559NH01OtherANTHEM
NH30007254Medicaid
NHAA39509OtherHARVARD PILGRIM
NH792609OtherMVP HEALTH CARE
NHAA39509OtherHARVARD PILGRIM