MS. Mallory Deanne Fairweather, PA-C
MS. Mallory Deanne Fairweather, PA-C is a Physician Assistant in Fayetteville, North Carolina. Qualified in 2022, 4 years ago. Practices with Id Care(r) - Infectious Diseases Specialty Practice PA, a 10-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.
- Years since qualifying
- 4
- Licensed in
- NC
- In the registry since
- 2022
- Specialties on file
- 2
What do these letters mean?
- PA-C — Physician Assistant, Certified
- A physician assistant who holds current national certification.
Practice location Address checks out
Fayetteville, NCNo coordinates on file. Search this address in Google Maps
Additional practice locations (1)
- 4350 Us 421 S, Lillington, NC 27546-6760 — (910) 893-1210
Specialties & licences
| Medical Physician Assistant (primary) | Taxonomy 363AM0700X (NC) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1770224438 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | PA-C |
| Sole proprietor | No |
| NPI enumerated | April 6, 2022 |
| Last updated in NPPES | August 11, 2025 |
| Certification date | August 11, 2025 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2022 (4 years in practice) |
| Group practice | Id Care(R) - Infectious Diseases Specialty Practice Pa — 10 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 3 on file with Medicare |
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