Provider Demographics
NPI:1558309187
Name:KAMAL, MALIHA (MD)
Entity Type:Individual
Prefix:DR
First Name:MALIHA
Middle Name:
Last Name:KAMAL
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:PO BOX 1112
Mailing Address - Street 2:1322 LOCUST AVE
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554
Mailing Address - Country:US
Mailing Address - Phone:304-366-0700
Mailing Address - Fax:304-366-9529
Practice Address - Street 1:1322 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554
Practice Address - Country:US
Practice Address - Phone:304-366-0700
Practice Address - Fax:304-366-9529
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21917207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV407115OtherCARELINK
WVI44819OtherWV WORKER'S COMP
WVP00269249OtherRR MEDICARE
WV001771616OtherMT STATE BC/BS
WVFQ21917OtherHEALTH PLAN
WV1558309187OtherOHIO WORKER'S COMP
WV3810003484Medicaid
WVP00269249OtherRR MEDICARE
WVKA4172261Medicare PIN