Provider Demographics
NPI:1699349142
Name:MALKAN, ABHISHEK
Entity type:Individual
Prefix:
First Name:ABHISHEK
Middle Name:
Last Name:MALKAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ABHISHEK
Other - Middle Name:NITIN
Other - Last Name:MALKAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:129 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4949
Practice Address - Country:US
Practice Address - Phone:803-774-9680
Practice Address - Fax:803-434-3955
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC83622208M00000X
SCLL83622207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine