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NPI Code Detail

MEDICARE: DR. MOHD AZFAR MALIK M.D.

MEDICARE: DR. MOHD AZFAR 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
12084P0800XPsychiatry PhysicianR2D07MO

General Provider Information

NPI Number : 1942208715
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOHD AZFAR MALIK M.D.
Provider Business Mailing Address
First Line : 5000 CEDAR PLAZA PKWY
Second Line : SUITE 350
City : SAINT LOUIS
State : MO
Zip : 63128-3854
Country : US
Telephone Number : 314-843-4333
Fax Number : 314-843-4856
Provider Business Practice Location Address
First Line : 763 S NEW BALLAS RD
Second Line : SUITE 110
City : SAINT LOUIS
State : MO
Zip : 63141-8704
Country : US
Telephone Number : 314-569-1717
Fax Number : 314-569-0441
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 09/13/2012

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