Provider Demographics
NPI:1831483510
Name:UMAIR MOIZ MALIK MD PC
Entity Type:Organization
Organization Name:UMAIR MOIZ MALIK MD PC
Other - Org Name:BRANDYWINE MEDICAL AND KIDNEY SPECIALIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-384-4100
Mailing Address - Street 1:3149 LINCOLN HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:THORNDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19372-1129
Mailing Address - Country:US
Mailing Address - Phone:610-384-4100
Mailing Address - Fax:610-441-7588
Practice Address - Street 1:3149 LINCOLN HWY
Practice Address - Street 2:SUITE C
Practice Address - City:THORNDALE
Practice Address - State:PA
Practice Address - Zip Code:19372-1129
Practice Address - Country:US
Practice Address - Phone:610-384-4100
Practice Address - Fax:610-441-7588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RN0300X, 207R00000X
NJ207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA256083OtherMEDICARE