Provider Demographics
NPI:1053317990
Name:ABDUL-MALAK, MICHAEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:ABDUL-MALAK
Suffix:
Gender:M
Credentials:MD
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 1318
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-0318
Mailing Address - Country:US
Mailing Address - Phone:724-347-4561
Mailing Address - Fax:724-347-4566
Practice Address - Street 1:2151 SHENANGO VALLEY FWY STE A-2
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2586
Practice Address - Country:US
Practice Address - Phone:724-347-4561
Practice Address - Fax:724-347-4566
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD052122L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001468424/0005Medicaid
PA001468424/0005Medicaid
PAF85568Medicare UPIN