Provider Demographics
NPI:1437645736
Name:MALIK, ERUM (PA-C)
Entity Type:Individual
Prefix:
First Name:ERUM
Middle Name:
Last Name:MALIK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 N GREEN VALLEY PKWY STE 5C
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5889
Mailing Address - Country:US
Mailing Address - Phone:702-541-8240
Mailing Address - Fax:702-541-8241
Practice Address - Street 1:1701 N GREEN VALLEY PKWY STE 5C
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5889
Practice Address - Country:US
Practice Address - Phone:702-541-8240
Practice Address - Fax:702-541-8241
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty