Provider Demographics
NPI:1750489225
Name:MALLARD MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:MALLARD MEDICAL SERVICES INC
Other - Org Name:SYED RASHEED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHEED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-255-6651
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:STANAFORD
Mailing Address - State:WV
Mailing Address - Zip Code:25927-0012
Mailing Address - Country:US
Mailing Address - Phone:304-255-6651
Mailing Address - Fax:304-255-6616
Practice Address - Street 1:20 MALLARD CT
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3615
Practice Address - Country:US
Practice Address - Phone:304-255-6651
Practice Address - Fax:304-255-6616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10638246Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVCE5101OtherRAILROAD MEDICARE
WV0008840000Medicaid
WV9170682Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER