Healthcare Provider Details

I. General information

NPI: 1912106691
Provider Name (Legal Business Name): FAISAL MALIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 MAIN ST
WILMINGTON MA
01887-2341
US

IV. Provider business mailing address

234 MAIN ST
WILMINGTON MA
01887-2341
US

V. Phone/Fax

Practice location:
  • Phone: 978-909-4966
  • Fax: 978-267-4189
Mailing address:
  • Phone: 978-909-4966
  • Fax: 978-267-4189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number240554
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: