Provider Demographics
NPI:1356703227
Name:MALAS, TAREK (MD)
Entity type:Individual
Prefix:
First Name:TAREK
Middle Name:
Last Name:MALAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:TAREK
Other - Middle Name:
Other - Last Name:MALAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9500 EUCLID AVE # J4-1
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-445-1652
Mailing Address - Fax:216-636-9215
Practice Address - Street 1:9500 EUCLID AVE # J4-1
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-1652
Practice Address - Fax:216-636-9215
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA75318208G00000X
GA075318208G00000X
OH35.131428208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)