Provider Demographics
NPI:1376864371
Name:MALIK, MOHSIN KAMAL (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHSIN
Middle Name:KAMAL
Last Name:MALIK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6 SHAWS CV STE 204
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4969
Mailing Address - Country:US
Mailing Address - Phone:860-440-3744
Mailing Address - Fax:860-440-3718
Practice Address - Street 1:6 SHAWS CV STE 204
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4969
Practice Address - Country:US
Practice Address - Phone:860-440-3744
Practice Address - Fax:860-440-3718
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2022-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT55875207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIU400298896Medicare PIN