Provider Demographics
NPI:1750543179
Name:MALLIK, NAMRATA (MD)
Entity type:Individual
Prefix:DR
First Name:NAMRATA
Middle Name:
Last Name:MALLIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:865 LINCOLN RD STE L10
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9200
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:615 VALLEY VIEW DR
Practice Address - Street 2:SUITE 204
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6150
Practice Address - Country:US
Practice Address - Phone:309-764-4500
Practice Address - Fax:309-762-2250
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008033794207R00000X
IL036121045207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine