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General NPI Number Information
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NPI Number | 1821352568
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Entity Type | Individual
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Provider Name | CHALLYN NICOLE MALONE MD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 169 ASHLEY AVE RM 202 MSC333
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City | CHARLESTON
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State | SC
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Zip | 29425-8905
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Country | US
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Telephone | 843-277-4642
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Fax |
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Provider Business Mailing Address
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Address Line | 2244 ASHLEY CROSSING DR UNIT 223
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City | CHARLESTON
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State | SC
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Zip | 29414-5700
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Country | US
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Telephone | 770-846-6231
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | LL34938
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 75741
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License Number State | GA
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