Healthcare Provider Details

I. General information

NPI: 1982851671
Provider Name (Legal Business Name): NADIA MALIK M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 CAMPUS DR
PLYMOUTH MN
55441-2649
US

IV. Provider business mailing address

2855 CAMPUS DR
PLYMOUTH MN
55441-2649
US

V. Phone/Fax

Practice location:
  • Phone: 763-577-7400
  • Fax: 800-507-8621
Mailing address:
  • Phone: 763-577-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number53090
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: