Provider Demographics
NPI:1700215399
Name:KOMAL A MALIK, MD, PC
Entity Type:Organization
Organization Name:KOMAL A MALIK, MD, PC
Other - Org Name:KOMAL A MALIK, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KOMAL
Authorized Official - Middle Name:ANWAR
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-604-7000
Mailing Address - Street 1:8315 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4830
Mailing Address - Country:US
Mailing Address - Phone:301-604-7000
Mailing Address - Fax:301-604-7005
Practice Address - Street 1:8315 CHERRY LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4830
Practice Address - Country:US
Practice Address - Phone:301-604-7000
Practice Address - Fax:301-604-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0067967207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty