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General NPI Number Information
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NPI Number | 1922260470
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Entity Type | Organization
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Legal Business Name | AMIR A MALIK MD PA
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 264 PALM COAST PKWY NE
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City | PALM COAST
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State | FL
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Zip | 32137-8217
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Country | US
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Telephone | 386-446-1940
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1779
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City | ST AUGUSTINE
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State | FL
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Zip | 32085-1779
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Country | US
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Telephone | 904-829-8300
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Fax | 904-829-8310
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMIR A MALIK
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Credential | MD
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Telephone | 904-829-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME50791
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License Number State | FL
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