Healthcare Provider Details

I. General information

NPI: 1629063904
Provider Name (Legal Business Name): HAMMAD MALIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MEDICAL DR NE STE 301
CARTERSVILLE GA
30121-8005
US

IV. Provider business mailing address

3390 PEACHTREE RD NE STE 1500
ATLANTA GA
30326-2822
US

V. Phone/Fax

Practice location:
  • Phone: 404-920-4950
  • Fax:
Mailing address:
  • Phone: 404-920-4950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number37055
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number37055
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number37055
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number92162
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number37055
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: