Provider Demographics
NPI:1730057076
Name:LOSER, MALLORY MCCORMACK (NP)
Entity type:Individual
Prefix:
First Name:MALLORY
Middle Name:MCCORMACK
Last Name:LOSER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 SLATER RD STE 205
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8463
Mailing Address - Country:US
Mailing Address - Phone:770-874-5475
Mailing Address - Fax:
Practice Address - Street 1:1750 KERNERSVILLE MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7146
Practice Address - Country:US
Practice Address - Phone:336-564-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5023384207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine