Individual
KELLY M MALENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
200 PATEWOOD DR, SUITE C300, GREENVILLE, SC 29615-3593
(864) 454-8272
(864) 454-2875
Mailing address
ONE INDEPENDENCE POINTE, SUITE 212, GREENVILLE, SC 29615-4566
(864) 797-6044
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1085
SC
363AS0400X
Surgical Physician Assistant
1085
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1085
—
SC
Enumeration date
05/24/2006
Last updated
09/16/2011
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