Provider Demographics
NPI:1760620355
Name:ALTHGAFI, MALAK (MD)
Entity Type:Individual
Prefix:
First Name:MALAK
Middle Name:
Last Name:ALTHGAFI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MALAK
Other - Middle Name:
Other - Last Name:ABEDALTHAGAFI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:855 EMORY POINT DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3800 RESERVOIR RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-444-2600
Practice Address - Fax:202-444-4859
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA93780207ZN0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program