Individual
LORI L. MALVERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
317 SAINT FRANCIS DR, SUITE 220, GREENVILLE, SC 29601-3965
(864) 255-1901
(844) 318-9058
Mailing address
317 SAINT FRANCIS DR, SUITE 220, GREENVILLE, SC 29601-3965
(864) 255-1901
(844) 318-9058
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16958
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110204017
RR MEDICARE
SC
05
—
169588
—
SC
01
—
576007863095
BCBS OF SC
SC
01
—
P00817212
RR MEDICARE
SC
Enumeration date
09/22/2006
Last updated
11/23/2015
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