Healthcare Provider Details

I. General information

NPI: 1073199436
Provider Name (Legal Business Name): MALEK ASFAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 METROHEALTH DR DEPARTMENT OF PATHOLOGY
CLEVELAND OH
44109
US

IV. Provider business mailing address

2500 METROHEALTH DR DEPARTMENT OF PATHOLOGY
CLEVELAND OH
44109
US

V. Phone/Fax

Practice location:
  • Phone: 216-778-4486
  • Fax:
Mailing address:
  • Phone: 216-778-4486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number57.250701
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number000
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: