Provider Demographics
NPI:1437113081
Name:MALEK, ANTHONY MARTIN (PT)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:MARTIN
Last Name:MALEK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 BURKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-1920
Mailing Address - Country:US
Mailing Address - Phone:443-752-5036
Mailing Address - Fax:
Practice Address - Street 1:2 COLGATE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2624
Practice Address - Country:US
Practice Address - Phone:410-879-7769
Practice Address - Fax:410-879-8545
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist