Provider Demographics
NPI:1952362527
Name:MALIK, UZMA (MD)
Entity Type:Individual
Prefix:DR
First Name:UZMA
Middle Name:
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 CENTURY MEDICAL DR STE A
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2157
Mailing Address - Country:US
Mailing Address - Phone:321-529-6102
Mailing Address - Fax:321-802-6863
Practice Address - Street 1:845 CENTURY MEDICAL DR STE A
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2157
Practice Address - Country:US
Practice Address - Phone:321-529-6102
Practice Address - Fax:321-802-6863
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4276262085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104296500Medicaid
PA097669Medicare ID - Type Unspecified
H09422Medicare UPIN