Provider Demographics
NPI:1447516331
Name:MALIS, JULIA (MD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:MALIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 APPLECROSS ROAD
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28388
Mailing Address - Country:US
Mailing Address - Phone:910-692-7928
Mailing Address - Fax:
Practice Address - Street 1:145 APPLECROSS ROAD
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28388
Practice Address - Country:US
Practice Address - Phone:910-692-7928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN59922207V00000X
DCMD044002207V00000X
NC2024-00224207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology