Provider Demographics
NPI:1578024311
Name:MALLES, AARON STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:STEVEN
Last Name:MALLES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 COLLEGE AVE SW # C
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5428
Mailing Address - Country:US
Mailing Address - Phone:287-575-5098
Mailing Address - Fax:
Practice Address - Street 1:906 COLLEGE AVE SW # C
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5428
Practice Address - Country:US
Practice Address - Phone:287-575-5098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2022-00955208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program