Healthcare Provider Details

I. General information

NPI: 1174765754
Provider Name (Legal Business Name): FAISAL SALEEM MALIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2009
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE OC.7.820
SEATTLE WA
98105
US

IV. Provider business mailing address

4800 SAND POINT WAY NE PO BOX 5371, M/S OC.7.820
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-0121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD60299979
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberMD60299979
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: