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Individual

KALISTA T MALETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
213 W 4TH NORTH ST, SUMMERVILLE, SC 29483-6541
(843) 873-0681
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(763) 348-2075

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5548
SC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
02/16/2024
Last updated
07/18/2025
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