Healthcare Provider Details

I. General information

NPI: 1225567944
Provider Name (Legal Business Name): BILAL TAREK MALEK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 06/23/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39555 ORCHARD HILL PL STE 600
NOVI MI
48375-5381
US

IV. Provider business mailing address

16001 W 9 MILE RD
SOUTHFIELD MI
48075-4818
US

V. Phone/Fax

Practice location:
  • Phone: 248-621-4581
  • Fax: 248-621-4582
Mailing address:
  • Phone: 248-849-8383
  • Fax: 248-849-2265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number4301502960
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301502960
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: