| Mohammad S Mallick Md Llc | |
|
1525 Liberty Ct Brookfield WI 53045-5327 | |
| (262) 646-6280 | |
| Not Available |
| Full Name | Mohammad S Mallick Md Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1525 Liberty Ct, Brookfield, Wisconsin |
| Authorized Official Name and Position | Mary K Duchin (MANAGER) |
| Authorized Official Contact | 2626466280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohammad S Mallick Md Llc 1525 Liberty Ct Brookfield WI 53045-5327 Ph: (262) 646-6280 | Mohammad S Mallick Md Llc 1525 Liberty Ct Brookfield WI 53045-5327 Ph: (262) 646-6280 |
| NPI Number | 1407048481 |
|---|---|
| Provider Enumeration Date | 08/14/2007 |
| Last Update Date | 08/14/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407048481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 27719 (Wisconsin) | Primary |
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