Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 11184 | SC |
NPI | 1063488203 |
---|---|
Provider Name | Rajeev Malik |
First Address | Anderson, SC 29621-1580 |
Second Address | Anderson, SC 29621-1580 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 09/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
111845 | (05) | SC |
D17624 | (02) | SC |