Provider Demographics
NPI:1639307663
Name:MALIK RHEUMATOLOGY, PA
Entity Type:Organization
Organization Name:MALIK RHEUMATOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RABIA
Authorized Official - Middle Name:BASIT
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-558-8788
Mailing Address - Street 1:2260 N RIDGE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1130
Mailing Address - Country:US
Mailing Address - Phone:316-558-8788
Mailing Address - Fax:316-558-8775
Practice Address - Street 1:2260 N RIDGE RD STE 210
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1130
Practice Address - Country:US
Practice Address - Phone:316-558-8788
Practice Address - Fax:316-558-8775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-31324207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty