Healthcare Provider Details

I. General information

NPI: 1689649592
Provider Name (Legal Business Name): MALAIKA HAKIMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 01/14/2020
Certification Date: 01/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO DRAWER 1911
FLOMATON AL
36441-1911
US

IV. Provider business mailing address

PO DRAWER 1911 1831 ROOSEVELT STREET
FLOMATON AL
36441-1911
US

V. Phone/Fax

Practice location:
  • Phone: 251-296-0136
  • Fax: 251-296-1916
Mailing address:
  • Phone: 251-296-0136
  • Fax: 251-296-1916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number12420
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: