Individual
TIMOTHY D MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 BLANDING ST, STE 4, COLUMBIA, SC 29201-2922
(803) 434-6771
(803) 434-3955
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
17355
SC
2084P0800X
Psychiatry Physician
Primary
17355
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173555
—
SC
01
—
582296052
PBMC BEHAVIORAL HEALTH
SC
Enumeration date
01/25/2006
Last updated
09/17/2021
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