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General NPI Number Information
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NPI Number | 1356542112
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Entity Type | Individual
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Provider Name | MALIK TARIQ RAHIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/29/2020
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Provider Practice Location Address
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Address Line | 2755 SILVER CREEK RD SUITE 217
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-7904
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Country | US
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Telephone | 928-704-6070
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Fax | 928-704-4736
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Provider Business Mailing Address
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Address Line | 10170 W TROPICANA AVE # 156-336
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City | LAS VEGAS
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State | NV
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Zip | 89147-8465
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Country | US
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Telephone | 702-659-7822
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Fax | 702-659-7805
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 14371
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 14371
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License Number State | NV
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