Laurie Lynn Malmstrom
Pediatric Emergency Physician
701 Grove Rd Gmh Er Administration
Greenville
, South Carolina 29605-5611
Laurie Lynn Malmstrom
Pediatric Emergency Physician
701 Grove Rd Gmh Er Administration
Greenville
, South Carolina 29605-5611
(864) 454-1130
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About
Features
Specialties
- Pediatric Emergency Physician
Languages spoken
- English
Location
First Address
- Laurie Lynn Malmstrom
- 255 Enterprise Blvd Suite 250
- Greenville, SC
- Zip : 29615-6300
- Fax : (864) 454-1130
- Phone : (864) 454-0888
Second Address
- Laurie Lynn Malmstrom
- 701 Grove Rd Gmh Er Administration
- Greenville, SC
- Zip : 29605-5611
- Phone : (864) 455-6372
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PP0204X | Pediatric Emergency Physician | 21139 | SC |
National Provider Identifier
| NPI | 1093732091 |
|---|---|
| Provider Name | Laurie Lynn Malmstrom |
| First Address | Greenville, SC 29615-6300 |
| Second Address | Greenville, SC 29605-5611 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/07/2006 |
| Last Update Date | 09/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 167193 | UNISON (01) | SC |
| 20004419 | SELECT HEALTH (01) | SC |
| 20-21139 | SCCS (01) | SC |
| 211390 | (05) | SC |
| 57-6007863 | BCBS (01) | SC |
| 57-6007863 | BLUE CHOICE (01) | SC |
| 57-6007863 | TRICARE (01) | SC |
| 930081471 | MEDICARE RAILROAD (01) | SC |
| BM5778177 | FEDERAL DEA (01) | SC |
| G67473 | (02) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.