Individual provider · Type 1 NPI

Norman Robert Mallory, PA-C

Medical Physician Assistant · Bangor, ME

NPI number 1710086608 Active

Practice location

360 Broadway Ste 100
Bangor, ME 04401-3979

Call (207) 907-3550 Map

Fax (207) 907-3562

Mailing address

C/o St Marys Health System - Provider Enrollment, PO Box 7291
Lewiston, ME 04243-7291

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA-692 (ME)

Medical Physician Assistant: Definition to come...

7 other providers at this address

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About NPI 1710086608

Norman Robert Mallory, PA-C's National Provider Identifier is 1710086608, issued on Sep 21, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Bangor, ME. The record was last updated on Feb 3, 2022.