Provider Demographics
NPI:1568402022
Name:MALIK, BAQIR ALI (MD)
Entity Type:Individual
Prefix:
First Name:BAQIR
Middle Name:ALI
Last Name:MALIK
Suffix:
Gender:M
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 ROAD
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:
Practice Address - Street 1:6492 N CANTON CENTER ROAD
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:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301070124208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics