Provider Demographics
NPI:1598864381
Name:MALTBIE, ALLAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:A
Last Name:MALTBIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:109 CONNER DR
Mailing Address - Street 2:BUILDING 3, SUITE 203
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7039
Mailing Address - Country:US
Mailing Address - Phone:919-929-1522
Mailing Address - Fax:919-929-1523
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-4996
Practice Address - Fax:919-843-5515
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC184642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8953794Medicaid
NC8953794Medicaid
NC208459EMedicare ID - Type Unspecified