Provider Demographics
NPI:1073669750
Name:MALEK, ABDOLLAH (MD)
Entity Type:Individual
Prefix:
First Name:ABDOLLAH
Middle Name:
Last Name:MALEK
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:ONE CENTURIAN DR.
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2127
Mailing Address - Country:US
Mailing Address - Phone:302-994-8492
Mailing Address - Fax:302-994-1155
Practice Address - Street 1:ONE CENTURIAN DR.
Practice Address - Street 2:SUITE 301
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2127
Practice Address - Country:US
Practice Address - Phone:302-994-8492
Practice Address - Fax:302-994-1155
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0001815208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000169801Medicaid
DE126833D38Medicare PIN
DE0000169801Medicaid