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General NPI Number Information
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NPI Number | 1497005359
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Entity Type | Individual
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Provider Name | MALIKA REMIE RAJENDRA OD
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Gender | Female
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 1012 GA HIGHWAY 96 STE 300
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City | WARNER ROBINS
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State | GA
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Zip | 31088-2506
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Country | US
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Telephone | 478-287-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 600 HWY 61
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City | VILLA RICA
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State | GA
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Zip | 30180
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Country | US
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Telephone |
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT002722
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License Number State | GA
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