Provider Demographics
NPI:1568722981
Name:MALIK, DEVIN BIRSINGH (MD)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:BIRSINGH
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 1:205 N. EAST AVENUE
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1753
Mailing Address - Country:US
Mailing Address - Phone:517-205-3867
Mailing Address - Fax:517-803-2133
Practice Address - Street 1:1100 E MICHIGAN AVE STE 307
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1850
Practice Address - Country:US
Practice Address - Phone:517-205-1594
Practice Address - Fax:517-205-5229
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301100683207R00000X, 207RH0000X, 207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology