Walter N. Malloy, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

0101027084 Issued in VA

Practice address

1101 Johnson Ave
Myrtle Beach, SC 29577-1893

Phone

(843) 477-0177

Fax

(843) 518-4022

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1619067261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1407",
            "city": "TAPPAHANNOCK",
            "state": "VA",
            "postal_code": "225601407",
            "telephone_number": "804-370-4093",
            "fax_number": "804-443-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 JOHNSON AVE",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771893",
            "telephone_number": "843-477-0177",
            "fax_number": "843-518-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "WALTER",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "VA",
            "license": "0101027084",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101027084",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101027084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6075886",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Grace Maietta
• Donna Michele Maisano, LISW-CP
• Sara Marie Major
• Matthew Malena, PT
• Olivia Anne Malich
• Liesl Eva Malone
• Michael Andrew Malone, M.D.
• Katelyn Maloney, CF-SLP
• Stacy D Maloney, LPC
• Man in the Box Anesthesia LLC

• Cardiovascular Disease Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Cardiovascular Disease Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.