Provider Demographics
NPI:1700879699
Name:MALLETTE, JULIUS Q (MD)
Entity type:Individual
Prefix:DR
First Name:JULIUS
Middle Name:Q
Last Name:MALLETTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:120 W MARTIN LUTHER KING JR DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-4906
Mailing Address - Country:US
Mailing Address - Phone:252-940-0602
Mailing Address - Fax:252-940-0924
Practice Address - Street 1:324 N QUEEN STREET
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-4932
Practice Address - Country:US
Practice Address - Phone:252-522-9800
Practice Address - Fax:252-523-9790
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC28261207VX0000X, 207VM0101X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2170961OtherMEDICARE
NC8953777Medicaid
NC53777OtherBCBS NC
NC160034966OtherRAILROAD MEDICARE
NC160034966OtherRAILROAD MEDICARE