Provider Demographics
NPI:1609055086
Name:MALIK A REHMAN MD, PA
Entity Type:Organization
Organization Name:MALIK A REHMAN MD, PA
Other - Org Name:NONE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MALIK
Authorized Official - Middle Name:ABDULREHMAN
Authorized Official - Last Name:AWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-242-5350
Mailing Address - Street 1:2717 HAMMONDS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-3100
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:21227-3100
Practice Address - Country:US
Practice Address - Phone:410-242-5350
Practice Address - Fax:410-242-4038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD229MMedicare PIN