Healthcare Provider Details

I. General information

NPI: 1952300584
Provider Name (Legal Business Name): ABDUL M MALIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: A MAJID MALIK M.D.

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 MUNSON AVE
TRAVERSE CITY MI
49686-3580
US

IV. Provider business mailing address

707 CEDAR ST STE 405
SOUTH BEND IN
46617-2059
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-6600
  • Fax:
Mailing address:
  • Phone: 574-335-8707
  • Fax: 574-335-0741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number4301113580
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01054291A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number01054291A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: