Provider Demographics
NPI:1063689974
Name:MALIK, AMARA (MD)
Entity Type:Individual
Prefix:DR
First Name:AMARA
Middle Name:
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 N MORELAND BLVD
Mailing Address - Street 2:APT 602
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1472
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2680 N MORELAND BLVD
Practice Address - Street 2:APT 602
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1472
Practice Address - Country:US
Practice Address - Phone:216-444-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.007183208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH57.007183OtherOHIO MEDICAL BOARD