Provider Demographics
NPI:1043282627
Name:MALEK, BACHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:BACHAR
Middle Name:
Last Name:MALEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4972 LINCOLN AVE
Mailing Address - Street 2:SUIT 101
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7909
Mailing Address - Country:US
Mailing Address - Phone:812-402-3700
Mailing Address - Fax:812-402-4611
Practice Address - Street 1:4972 LINCOLN AVE
Practice Address - Street 2:SUIT 101
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-7909
Practice Address - Country:US
Practice Address - Phone:812-402-3700
Practice Address - Fax:812-402-4611
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061287A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000618302OtherANTHEM BLUE CROSS
IN200807410Medicaid
IN200807410Medicaid