Individual
KIMBERLY N MALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-0100
(843) 792-1414
Mailing address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21724
SC
207Q00000X
Family Medicine Physician
292697
NY
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
21724
SC
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
292697
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217243
—
SC
Enumeration date
05/02/2006
Last updated
05/09/2026
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