MEDICARE: FARZANA MALIK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	15077	MS
2	208000000X	Pediatrics Physician	65722	GA
3	208000000X	Pediatrics Physician	23576	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013986827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARZANA MALIK M.D.

Provider Business Mailing Address
First Line	:	2850 DR JOHN HAYNES DR
Second Line	:
City	:	PELL CITY
State	:	AL
Zip	:	35125-1438
Country	:	US
Telephone Number	:	205-884-2260
Fax Number	:	205-884-2351

Provider Business Practice Location Address
First Line	:	2850 DR JOHN HAYNES DR
Second Line	:
City	:	PELL CITY
State	:	AL
Zip	:	35125-1438
Country	:	US
Telephone Number	:	205-884-2260
Fax Number	:	205-884-2351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	05/11/2017

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