Provider Demographics
NPI:1609007582
Name:MALIK, RIZWAN (MD)
Entity Type:Individual
Prefix:
First Name:RIZWAN
Middle Name:
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:SUITE 50 22201 MOROSS RD.
Mailing Address - Street 2:ST. JOHN HOSPITAL AND MEDICAL CENTER IMSC PB2
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:313-343-4242
Mailing Address - Fax:
Practice Address - Street 1:SUITE 50 22201 MOROSS RD.
Practice Address - Street 2:ST. JOHN HOSPITAL AND MEDICAL CENTER IMSC PB2
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236
Practice Address - Country:US
Practice Address - Phone:313-343-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2398707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine