Provider Demographics
NPI:1255499653
Name:MALINICS, MICHAEL C (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:MALINICS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421718
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29442-4203
Mailing Address - Country:US
Mailing Address - Phone:843-652-8226
Mailing Address - Fax:
Practice Address - Street 1:4040 HIGHWAY 17 UNIT 202
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-5098
Practice Address - Country:US
Practice Address - Phone:843-235-3131
Practice Address - Fax:203-709-5545
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2021-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000239207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001002394Medicaid
CT020239-7359OtherCONNECTICARE
CT040000239CT08OtherANTHEM BCBS CT
CT1255499653Medicaid
CT415474OtherWELLCARE
CTP3837931OtherOXFORD
CT4250662OtherAETNA
CT1086984OtherUSA
CT21-50233OtherUHC
CTP00453279OtherRR MEDICARE
CT21-50233OtherAMERICHOICE
CT2V9983OtherHEALTHNET/COMMERCIAL
CT060001839Medicare PIN
CT001002394Medicaid
CT060001839Medicare PIN