Healthcare Provider Details

I. General information

NPI: 1689290843
Provider Name (Legal Business Name): BILAL MALIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1761 BEALL AVE STE 101
WOOSTER OH
44691-2342
US

IV. Provider business mailing address

1761 BEALL AVE STE 101
WOOSTER OH
44691-2342
US

V. Phone/Fax

Practice location:
  • Phone: 330-462-7001
  • Fax: 330-263-8169
Mailing address:
  • Phone: 330-462-7001
  • Fax: 330-263-8169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35.156690
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35.156690
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.156690
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: