Komal A Malik, Md | |
8315 Cherry Ln Laurel MD 20707-4830 | |
(301) 604-7000 | |
(301) 604-7005 |
Full Name | Komal A Malik, Md |
---|---|
Speciality | Family Medicine |
Location | 8315 Cherry Ln, Laurel, Maryland |
Authorized Official Name and Position | Komal Anwar Malik (OWNER) |
Authorized Official Contact | 3016047000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Komal A Malik, Md 8315 Cherry Ln Laurel MD 20707-4830 Ph: (301) 604-7000 | Komal A Malik, Md 8315 Cherry Ln Laurel MD 20707-4830 Ph: (301) 604-7000 |
NPI Number | 1700215399 |
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Provider Enumeration Date | 11/05/2013 |
Last Update Date | 11/05/2013 |
Medicare PECOS PAC ID | 8527296748 |
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Medicare Enrollment ID | O20140116000236 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700215399 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | D0067967 (Maryland) | Primary |
Provider Name | Komal A Malik |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1730339995 PECOS PAC ID: 4486701547 Enrollment ID: I20120808000010 |
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