Provider Demographics
NPI:1568483493
Name:REHMAN, MALIK A (MD)
Entity Type:Individual
Prefix:
First Name:MALIK
Middle Name:A
Last Name:REHMAN
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 1:2717 HAMMONDS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-3138
Mailing Address - Country:US
Mailing Address - Phone:410-242-5350
Mailing Address - Fax:410-242-4038
Practice Address - Street 1:2717 HAMMONDS FERRY RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227
Practice Address - Country:US
Practice Address - Phone:410-242-5350
Practice Address - Fax:410-242-4038
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD25044207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD786191500Medicaid
C49296Medicare UPIN
MD786191500Medicaid