Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | LL27196 | SC |
N | 111NI0900X | Internist | LL27196 | SC |
Y | 207RG0100X | Gastroenterologist | 27196 | SC |
NPI | 1043395650 |
---|---|
Provider Name | Meghan Lynne Malone |
First Address | Conway, SC 29528-2180 |
Second Address | Conway, SC 29526-8994 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 05/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
271967 | (05) | SC |
AA5620 | (02) | SC |