Healthcare Provider Details

I. General information

NPI: 1063488203
Provider Name (Legal Business Name): RAJEEV MALIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 E GREENVILLE ST STE 5000
ANDERSON SC
29621-1580
US

IV. Provider business mailing address

2000 E GREENVILLE ST STE 5000
ANDERSON SC
29621-1580
US

V. Phone/Fax

Practice location:
  • Phone: 864-224-5765
  • Fax: 864-224-1449
Mailing address:
  • Phone: 864-224-5765
  • Fax: 864-224-1449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number11184
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: