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NPI Code Detail

MEDICARE: KATHLEEN RUTH MALANEY MD

MEDICARE: KATHLEEN RUTH MALANEY MD
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 Physician3114SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780682195
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN RUTH MALANEY MD
Provider Business Mailing Address
First Line : 6 43RD AVE
Second Line :
City : ISLE OF PALMS
State : SC
Zip : 29451-2604
Country : US
Telephone Number : 843-886-4974
Fax Number : 843-886-4430
Provider Business Practice Location Address
First Line : 1202 PALM BLVD
Second Line : SUITE A
City : ISLE OF PALMS
State : SC
Zip : 29451-2296
Country : US
Telephone Number : 843-886-4402
Fax Number : 843-886-4430
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2005
Last Update Date : 07/21/2022

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Directions to “ KATHLEEN RUTH MALANEY MD” Practice Location

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