MEDICARE: DR. FARZANA MALIK M.D.

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	207R00000X	Internal Medicine Physician	ME102952	FL

General Provider Information

NPI Number	:	1235342726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARZANA MALIK M.D.

Provider Business Mailing Address
First Line	:	2527 MACNAUGHTEN ST NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720
Country	:	US
Telephone Number	:	330-305-6762
Fax Number	:	330-305-6762

Provider Business Practice Location Address
First Line	:	2527 MACNAUGHTEN ST NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720
Country	:	US
Telephone Number	:	330-305-6762
Fax Number	:	330-305-6762

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	11/17/2008

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