DR. ERIC JOHN MALLICO (NPI# 1790813863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790813863 |
| Entity Type | Individual |
| Full Name | DR. ERIC JOHN MALLICO |
| Credential | MD |
| Practice Address |
105 Yadkin St Suite 203 Albemarle NC 28001-3449 |
| Mailing Address |
320 Yadkin St Suite B Albemarle NC 28001-3447 |
| Practice Telephone | 7049820161 |
| Practice Fax Number | 7049822361 |
| Mailing Telephone | 7049837320 |
| Mailing Fax Number | 7049836153 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 116331 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 1511E | 01 |
| NC | 5910179 | 05 |
| Street Address |
105 YADKIN ST SUITE 203 |
| City | ALBEMARLE |
| State | NC |
| Zip Code | 28001-3449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629071642 | Philip Jones | Obstetrics & Gynecology | 105 Yadkin St, Ste 102, Albemarle, NC 28001-3449 | 2005-05-23 |
| 1881047488 | Tammy Luanne Ikner | Pharmacist | 105 Yadkin St, Suite 103, Albemarle, NC 28001-3449 | 2016-07-19 |
| 1366895070 | Sean Pickler | Pharmacist | 105 Yadkin St, Suite 103, Albemarle, NC 28001-3449 | 2016-07-18 |
| 1881047595 | Courtney Owens | Pharmacist | 105 Yadkin St, Ste 103, Albemarle, NC 28001-3449 | 2016-07-18 |
| 1396127577 | Aleshia Gaddy | Physician Assistant | 105 Yadkin St, Ste 303, Albemarle, NC 28001-3449 | 2015-06-23 |
| 1386036390 | Ellen Snyder | Nurse Practitioner | 105 Yadkin St, Ste 301, Albemarle, NC 28001-3449 | 2015-02-27 |
| 1902200991 | Carolinas Physicians Network Inc | Pediatrics | 105 Yadkin St, Ste 303, Albemarle, NC 28001-3449 | 2014-10-20 |
| 1679977730 | Carolinas Physicians Network Inc | Surgery | 105 Yadkin St, Ste 203, Albemarle, NC 28001-3449 | 2014-10-20 |
| 1336543495 | Carolinas Physicians Network Inc | Orthopaedic Surgery | 105 Yadkin St, Ste 101, Albemarle, NC 28001-3449 | 2014-10-20 |
| 1255735312 | Carolinas Physicians Network Inc | Internal Medicine | 105 Yadkin St, Ste 301, Albemarle, NC 28001-3449 | 2014-10-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649835828 | Ashley M Duncan | Physician Assistant | Atrium Stanly Emergent Department, 320 Yadkin St, Albermarle, NC 28001 | 2019-05-03 |
| 1659870616 | Crystal Hamilton | Home Health Aide | 1741 West Main Street, Albemarble, NC 28001 | 2018-02-06 |
| 1548703358 | J. Lemmons, Dds and Associates, Pa | Clinic/Center | 319 North Second Street, Albemarle, NC 28001 | 2016-11-28 |
| 1265807937 | Novant Medical Group, Inc | Orthopaedic Surgery | 1420 Us Highway 52, Suite B, Albemarle, NC 28001 | 2015-12-07 |
| 1053785220 | Novant Medical Group, Inc. | Surgery | 1420 Us Highway North 52, Suite B, Albermarle, NC 28001 | 2015-11-25 |
| 1942674775 | The Charlotte-mecklenburg Hospital Authority | Skilled Nursing Facility | 625 Bethany Road, Albemarle, NC 28001 | 2015-11-17 |
| 1508248279 | Athena Vu Dds Pllc. | Dentist | 1122 North 6th Street, Albemarle, NC 28001 | 2015-06-18 |
| 1629482054 | Erika Shew | Pharmacist | 835 North Carolina 24, Albemarle, NC 28001 | 2014-06-13 |
| 1558794974 | Ted Allen Thompson Jr. | Pharmacist | 835 Hwy 24-27, Albemarle, NC 28001 | 2013-08-21 |
| 1912349606 | Elite Care Services Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 33973 Lowder Reunion Rd, Albemarle, NC 28001 | 2013-07-23 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104005602 | Stibal Surgical Center | Surgery | 303c Yadkin St, Albemarle, NC 28001-3441 | 2007-10-31 |
| 1508803198 | Albermarle Surgical Clinic, P.a. | Surgery | 311 Yadkin St, Albemarle, NC 28001-3441 | 2006-06-01 |
| 1679977730 | Carolinas Physicians Network Inc | Surgery | 105 Yadkin St, Ste 203, Albemarle, NC 28001-3449 | 2014-10-20 |
| 1013247469 | Alla Zemlyak | Surgery | 105 Yadkin St, Ste 203, Albemarle, NC 28001-3449 | 2010-01-07 |
| 1750518718 | Matthew Shaver | Surgery | 105 Yadkin St, Ste 203, Albemarle, NC 28001-3449 | 2009-06-17 |
| 1285803304 | Stanly Medical Services | Surgery | 105 Yadkin St, Suite 203, Albemarle, NC 28001-3449 | 2008-02-22 |
| 1225251796 | Brian D Allen Md Pllc | Surgery | 923 North Second Street, Suite 205, Albemarle, NC 28001-3370 | 2007-04-11 |
| 1336277607 | Jason Arru | Surgery | 105 Yadkin St, Ste 203, Albemarle, NC 28001-3449 | 2007-03-01 |
| 1548339146 | Mouza Goova | Surgery | 105 Yadkin St, Suite 203, Albemarle, NC 28001-3449 | 2006-11-07 |
| 1427141472 | David Lipsi | Surgery | 105 Yadkin St, Suite 203, Albemarle, NC 28001-3449 | 2006-10-02 |
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| 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.