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NPI Code Detail

MEDICARE: DR. MICHAEL ANDREW MALONE M.D.

MEDICARE: DR. MICHAEL ANDREW MALONE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD437004PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MD437004OTHERPAMEDICAL LICENSE

General Provider Information

NPI Number : 1912980210
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL ANDREW MALONE M.D.
Provider Business Mailing Address
First Line : PO BOX 421718
Second Line :
City : GEORGETOWN
State : SC
Zip : 29442-4203
Country : US
Telephone Number : 843-652-8226
Fax Number :
Provider Business Practice Location Address
First Line : 4320 HOLMESTOWN RD
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-7837
Country : US
Telephone Number : 843-652-8440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2005
Last Update Date : 03/28/2021

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