Michael Craig Mallea
Nephrologist
4620 Enterprise Way Ste 101
Caldwell
, Idaho 83605
Michael Craig Mallea
Nephrologist
4620 Enterprise Way Ste 101
Caldwell
, Idaho 83605
(208) 846-8336
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About
Features
Specialties
- Nephrologist
Languages spoken
- English
Location
First Address
- Michael Craig Mallea
- 3525 E Louise Dr Ste 195
- Meridian, ID
- Zip : 83642-6303
- Fax : (208) 846-8336
- Phone : (208) 846-8335
Second Address
- Michael Craig Mallea
- 4620 Enterprise Way Ste 101
- Caldwell, ID
- Zip : 83605
- Fax : (208) 846-8336
- Phone : (208) 846-8335
Reviews
FAQs
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Is Michael Craig Mallea a sole practitioner?
Is Michael Craig Mallea accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RN0300X | Nephrologist | M7108 | ID |
| Y | 207RN0300X | Nephrologist | MD20251 | OR |
National Provider Identifier
| NPI | 1043235377 |
|---|---|
| Provider Name | Michael Craig Mallea |
| First Address | Meridian, ID 83642-6303 |
| Second Address | Caldwell, ID 83605 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/07/2006 |
| Last Update Date | 26/11/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000010002160 | BLUE SHIELD (01) | ID |
| 003813700 | (05) | ID |
| 12252 | BLUE CROSS (01) | ID |
| 150023 | (05) | OR |
| 390004362 | RR MEDICARE (01) | ID |
| A01620 | (02) | ID |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.