Provider Demographics
NPI:1740575497
Name:MALAN, KATHRYN MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:MICHELLE
Last Name:MALAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:125 FLORIDA MEMORIAL PKWY STE 2500
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-9315
Mailing Address - Country:US
Mailing Address - Phone:386-409-6857
Mailing Address - Fax:386-409-6911
Practice Address - Street 1:125 FLORIDA MEMORIAL PKWY STE 2500
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-9315
Practice Address - Country:US
Practice Address - Phone:386-409-6857
Practice Address - Fax:386-409-6911
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2021-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLTRN16249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine