STEPHEN M MALOFF MD PA (NPI# 1417155284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417155284 |
| Entity Type | Organization |
| Organization Name | STEPHEN M MALOFF MD PA |
| Practice Address |
1950 E Clark Street Suite A Pocatello ID 83205 |
| Mailing Address |
Po Box 4948 1950 E Clark Street Suite A Pocatello ID 83205 |
| Practice Telephone | 2082325550 |
| Practice Fax Number | 2082325553 |
| Mailing Telephone | 2082325550 |
| Mailing Fax Number | 2082325553 |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | STEPHEN M MALOFF (PHYSICIAN) |
| Authorized Official Telephone | 2082325550 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
M3508 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | D03833100 | 05 |
| Street Address |
1950 E CLARK STREET SUITE A |
| City | POCATELLO |
| State | ID |
| Zip Code | 83205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528054830 | Super Save Drug | Durable Medical Equipment & Medical Supplies | 701 East Center, Pocatello, ID 83205-4869 | 2005-09-22 |
| 1912993213 | Super Save Drug, Inc | Pharmacy | 701 East Center St., Pocatello, ID 83205-4869 | 2005-09-22 |
| 1689945883 | Thomas John Mcdevitt | Otolaryngology | 237 South 7th Ave., Thomas J. Mcdevitt, Pocatello, ID 83205-4928 | 2012-01-19 |
| 1013306307 | 1958 | General Acute Care Hospital | 730 E Clark St, #4657, Pocatello, ID 83205-5401 | 2015-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033484 | Ala, LLC | Case Management | 818 E Lander St, Pocatello, ID 83201-5763 | 2020-11-04 |
| 1639779523 | Tracie Lyn Hansen | Peer Specialist | 560 Fairway Dr, Pocatello, ID 83201-2012 | 2020-10-29 |
| 1104424191 | Jo Anna Shotiveyaratana | Counselor | 707 W Wyeth St, Pocatello, ID 83204-3058 | 2020-10-13 |
| 1811595929 | Idaho State University | Counselor | 1400 E Terry Dr Bldg 63, Pocatello, ID 83209-0001 | 2020-10-12 |
| 1871190215 | Cardiovascular Specialists of America, LLC | Internal Medicine | 1515 E Clark St, Pocatello, ID 83201-4133 | 2020-10-08 |
| 1568078046 | Peter Chad Adamovich | Pharmacist | 3553 Summit Dr, Pocatello, ID 83201-8011 | 2020-09-19 |
| 1639784648 | Alyssa Mabey | Occupational Therapy Assistant | 659 Fairway Dr, Pocatello, ID 83201-2049 | 2020-09-15 |
| 1023622321 | Jessica Michelle Wilson-lucero | Psychologist | 395 1/2 Willard Ave, Pocatello, ID 83201-4524 | 2020-09-03 |
| 1316551187 | Atropos Mental Health | Case Management | 217 S 9th Ave, Pocatello, ID 83201-5351 | 2020-08-31 |
| 1265045199 | Julia Claire Brodie | Physician Assistant | 2352 N Apple Ln, Pocatello, ID 83204-7231 | 2020-08-29 |
| Find all providers in POCATELLO | ||||
| Taxonomy Code | 2082S0099X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| Specialization | Plastic Surgery Within the Head and Neck |
| A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. A subspecialty certificate was approved by the ABMS in 2000. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316059280 | Stephen M Maloff | Plastic Surgery | 2240 E Center St, Pocatello, ID 83201 | 2006-08-31 |
| 1578675443 | Silas Angier Wills Jr. | Plastic Surgery | 1950 E Clark St, Ste A, Pocatello, ID 83201 | 2006-08-31 |
Please comment or provide details below to improve the information on STEPHEN M MALOFF MD PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.