Healthcare Provider Details

I. General information

NPI: 1326345588
Provider Name (Legal Business Name): MALIK MUHAMMAD PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2011
Last Update Date: 09/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 W COLONY PL STE 280
DURHAM NC
27705-5591
US

IV. Provider business mailing address

20 W COLONY PL STE 280
DURHAM NC
27705-5591
US

V. Phone/Fax

Practice location:
  • Phone: 800-984-3167
  • Fax: 815-642-0216
Mailing address:
  • Phone: 800-984-3167
  • Fax: 815-642-0216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4438
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: