Provider Demographics
NPI:1932110640
Name:MALIK, SHAHAB (MD)
Entity Type:Individual
Prefix:
First Name:SHAHAB
Middle Name:
Last Name:MALIK
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:1414 CRAIN HWY N
Mailing Address - Street 2:UNIT 6A
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-7001
Mailing Address - Country:US
Mailing Address - Phone:410-582-9630
Mailing Address - Fax:410-582-9653
Practice Address - Street 1:1414 CRAIN HWY N
Practice Address - Street 2:UNIT 6A
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-7001
Practice Address - Country:US
Practice Address - Phone:410-582-9630
Practice Address - Fax:410-582-9653
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD00577422080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine