| Dylan Malloy, PA-C | |
|
11300 Cresthill Dr Ste 120, Mint Hill, NC 28227-7924 | |
| (704) 438-9479 | |
| (704) 438-9478 |
| Full Name | Dylan Malloy |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 10 Years |
| Location | 11300 Cresthill Dr Ste 120, Mint Hill, North Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275988990 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | (Connecticut) | Secondary |
| 363A00000X | Physician Assistant | 0010-09649 (North Carolina) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Carolina Medicorp Enterprises Llc | 0648174904 | 184 |
| Entity Name | Carolina Medicorp Enterprises LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760950646 PECOS PAC ID: 0648174904 Enrollment ID: O20040110000190 |
| Mailing Address | Practice Location Address |
|---|---|
| Dylan Malloy, PA-C Po Box 601843, Charlotte, NC 28260-1843 Ph: Not Available | Dylan Malloy, PA-C 11300 Cresthill Dr Ste 120, Mint Hill, NC 28227-7924 Ph: (704) 438-9479 |
Selena Houck, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 11304 Hawthorne Dr Ste 100, Mint Hill, NC 28227 Phone: 704-545-6400 |
Abigail Christine Lisowski, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 11304 Hawthorne Dr, Ste 100, Mint Hill, NC 28227 Phone: 704-545-6400 |
Kiran Deep Semelsberger, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 11304 Hawthorne Dr, Ste 100, Mint Hill, NC 28227 Phone: 704-545-6400 |
Kristen Jones, Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 9150 Morgan Glenn Dr, Mint Hill, NC 28227 Phone: 614-806-3474 |
Melissa A Vanausdoll, PAC Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 7110 Lawyers Rd, Mint Hill, NC 28227 Phone: 704-537-0020 Fax: 704-537-2144 |
Sharyce Nicole Banks, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 11300 Cresthill Dr Ste 120, Mint Hill, NC 28227 Phone: 704-438-9479 |
Rosemary Grullon, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 11304 Hawthorne Dr, Suite 100, Mint Hill, NC 28227 Phone: 704-545-6400 |