Healthcare Provider Details

I. General information

NPI: 1477819076
Provider Name (Legal Business Name): SARAH MALIK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 07/21/2021
Certification Date: 07/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 W SAGINAW ST
LANSING MI
48915-1927
US

IV. Provider business mailing address

1210 W SAGINAW ST
LANSING MI
48915-1927
US

V. Phone/Fax

Practice location:
  • Phone: 511-364-7700
  • Fax:
Mailing address:
  • Phone: 517-364-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number4301108789
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: