Provider Demographics
NPI:1336100296
Name:MALIK, KHALID JAVAID (MD)
Entity Type:Individual
Prefix:
First Name:KHALID
Middle Name:JAVAID
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 1:490 E NORTH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4771
Mailing Address - Country:US
Mailing Address - Phone:412-322-7202
Mailing Address - Fax:412-322-2144
Practice Address - Street 1:490 E NORTH AVE
Practice Address - Street 2:STE 300
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4771
Practice Address - Country:US
Practice Address - Phone:412-322-7202
Practice Address - Fax:412-322-2144
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066040L207RC0200X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017427930004Medicaid
OH0069406Medicaid
WV3810001345Medicaid
WV3810001345Medicaid
PAP00967045Medicare PIN
OH0069406Medicaid
WV3810001345Medicaid