Provider Demographics
NPI:1558995191
Name:MALIK, SULEMAN
Entity Type:Individual
Prefix:
First Name:SULEMAN
Middle Name:
Last Name:MALIK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 WILD BIRD DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-8383
Mailing Address - Country:US
Mailing Address - Phone:734-218-2862
Mailing Address - Fax:
Practice Address - Street 1:4726 GREENFIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-4124
Practice Address - Country:US
Practice Address - Phone:313-633-9310
Practice Address - Fax:313-633-9706
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-22
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302043386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist