MEDICARE: PARVEEN AKHTER MALIK MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	4301065126	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	010090049 2	OTHER	MI	BCBSMI PIN

General Provider Information

NPI Number	:	1063691640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARVEEN AKHTER MALIK MD PC

Provider Business Mailing Address
First Line	:	808 N EUCLID AVE
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-2474
Country	:	US
Telephone Number	:	989-686-3760
Fax Number	:	989-686-5615

Provider Business Practice Location Address
First Line	:	808 N EUCLID AVE
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-2474
Country	:	US
Telephone Number	:	989-686-3760
Fax Number	:	989-686-5615

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PARVEEN AKHTER MALIK
Credential	:	M.D.
Telephone Number	:	989-686-3760

Provider Enumeration Date	:	10/30/2007
Last Update Date	:	10/30/2007

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