Provider Demographics
NPI:1578574216
Name:MALIK, ASIFA MAHBOOB (MD)
Entity Type:Individual
Prefix:
First Name:ASIFA
Middle Name:MAHBOOB
Last Name:MALIK
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 1:1005 9TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5853
Mailing Address - Country:US
Mailing Address - Phone:260-416-8611
Mailing Address - Fax:
Practice Address - Street 1:1005 9TH ST APT 3
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5853
Practice Address - Country:US
Practice Address - Phone:260-416-8611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062625208M00000X
WV27704207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000488057OtherANTHEM
P00390080OtherRAILROAD
IN200838230Medicaid
INI65539Medicare UPIN
P00390080OtherRAILROAD