Provider Demographics
NPI:1497816623
Name:MALIK, KAUSER (MD)
Entity Type:Individual
Prefix:DR
First Name:KAUSER
Middle Name:
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6492 N CANTON CENTER DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2660
Mailing Address - Country:US
Mailing Address - Phone:734-254-1900
Mailing Address - Fax:734-254-1951
Practice Address - Street 1:6492 N CANTON CENTER DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2660
Practice Address - Country:US
Practice Address - Phone:734-254-1900
Practice Address - Fax:734-254-1951
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301071909208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301071909OtherSTATE LICENSE NUMBER
MIBM8112156OtherCONTROLLED STATE REGISTRA