Provider Demographics
NPI:1508045535
Name:MALIK MEDICAL ASSOCIATES,INC
Entity Type:Organization
Organization Name:MALIK MEDICAL ASSOCIATES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:K
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-763-1411
Mailing Address - Street 1:834 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16226-1105
Mailing Address - Country:US
Mailing Address - Phone:724-763-1411
Mailing Address - Fax:724-763-1068
Practice Address - Street 1:834 4TH AVE
Practice Address - Street 2:
Practice Address - City:FORD CITY
Practice Address - State:PA
Practice Address - Zip Code:16226-1105
Practice Address - Country:US
Practice Address - Phone:724-763-1411
Practice Address - Fax:724-763-1068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037698L171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA112238OtherBLUE SHIELDS
PA112238OtherBLUE SHIELDS