Provider Demographics
NPI:1962673822
Name:KHALID M MALIK MD PC
Entity Type:Organization
Organization Name:KHALID M MALIK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALID
Authorized Official - Middle Name:MASOOD
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-792-4440
Mailing Address - Street 1:70 N FROST DR
Mailing Address - Street 2:STE 1
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-5796
Mailing Address - Country:US
Mailing Address - Phone:989-792-4440
Mailing Address - Fax:989-792-0685
Practice Address - Street 1:70 N FROST DR
Practice Address - Street 2:STE 1
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-5796
Practice Address - Country:US
Practice Address - Phone:989-792-4440
Practice Address - Fax:989-792-0685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P56650Medicare PIN