Provider Demographics
NPI:1518909605
Name:MALIK, SHAMIM A (MD)
Entity Type:Individual
Prefix:
First Name:SHAMIM
Middle Name:A
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1325 HEARTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:AR
Mailing Address - Zip Code:71602
Mailing Address - Country:US
Mailing Address - Phone:870-543-9820
Mailing Address - Fax:870-534-5798
Practice Address - Street 1:DELTA MEMORIAL HOSPITAL
Practice Address - Street 2:811 HIGHWAY 65 SOUTH
Practice Address - City:DUMAS
Practice Address - State:AR
Practice Address - Zip Code:71639
Practice Address - Country:US
Practice Address - Phone:870-382-8234
Practice Address - Fax:870-382-6555
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE00622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE0062OtherSTATE LICENSE
AR126148001Medicaid
ARE0062OtherSTATE LICENSE
AR5J4976979Medicare PIN