Active NPI
L Suzanne Mallow, MD
- Family Medicine Physician
- Florence, SC
National Provider Identifier
1194780874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 12722
- Practice address
- 600 E Palmetto St
Florence, SC 29506-2851 - Phone
- (843) 667-9414
- Fax
- (843) 667-1282
- NPI assigned
- Apr 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 12722 | SC | Primary |
Addresses
Primary practice location
600 E Palmetto St
Florence, SC 29506-2851
Mailing address
600 E Palmetto St
Florence, SC 29506-2851
Phone (843) 667-9414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 127222 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12722 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294099200000",
"number": "1194780874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 E PALMETTO ST",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295062851",
"telephone_number": "843-667-9414",
"fax_number": "843-667-1282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E PALMETTO ST",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295062851",
"telephone_number": "843-667-9414",
"fax_number": "843-667-1282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLOW",
"first_name": "L",
"middle_name": "SUZANNE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-18",
"last_updated": "2011-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "12722",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "127222",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Florence, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.