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General NPI Number Information
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NPI Number | 1144743923
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Entity Type | Organization
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Legal Business Name | AMIR G ABDELMALIK MD PLLC
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Dates
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Enumeration Date | 07/24/2017
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 6711 S YALE AVE STE 104
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City | TULSA
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State | OK
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Zip | 74136-3317
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Country | US
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Telephone | 918-522-7200
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Fax | 918-522-7201
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Provider Business Mailing Address
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Address Line | 14024 ROSE LODGE PL
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City | CHANTILLY
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State | VA
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Zip | 20151-2247
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Country | US
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Telephone | 917-757-8549
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | DR. AMIR G ABDELMALIK
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Credential | MD
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Telephone | 917-757-8549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | 28935
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License Number State | OK
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