Healthcare Provider Details

I. General information

NPI: 1447284864
Provider Name (Legal Business Name): MUHAMMAD FAYAZ MALIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 MEDICAL CENTER PKWY STE 201
MURFREESBORO TN
37129-3237
US

IV. Provider business mailing address

1840 MEDICAL CENTER PKWY STE 201
MURFREESBORO TN
37129-3237
US

V. Phone/Fax

Practice location:
  • Phone: 615-867-5028
  • Fax: 615-867-6650
Mailing address:
  • Phone: 615-867-5028
  • Fax: 615-867-6650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number53353
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number53353
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: