Provider Demographics
NPI:1306822275
Name:MALIK, NADEEM N (MD)
Entity Type:Individual
Prefix:DR
First Name:NADEEM
Middle Name:N
Last Name:MALIK
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 1:8593 RAINTREE RUN
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-2988
Mailing Address - Country:US
Mailing Address - Phone:330-757-1957
Mailing Address - Fax:
Practice Address - Street 1:1622 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6613
Practice Address - Country:US
Practice Address - Phone:330-399-7215
Practice Address - Fax:330-399-2411
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18936207ZP0102X
OH35065221207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1803568000Medicaid
OH2419538Medicaid
OH35-065221OtherOHIO LICENSE
F03848Medicare UPIN