MEDICARE: DR. HAKEEM MALIN DNP, PRACTITIONER

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	363LG0600X	Gerontology Nurse Practitioner	APRN.CNP.020612	OH

General Provider Information

NPI Number	:	1508397860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAKEEM MALIN DNP, PRACTITIONER

Provider Business Mailing Address
First Line	:	1000 GEORGESVILLE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-3304
Country	:	US
Telephone Number	:	614-274-7771
Fax Number	:	614-274-7720

Provider Business Practice Location Address
First Line	:	1000 GEORGESVILLE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-3304
Country	:	US
Telephone Number	:	614-274-7771
Fax Number	:	614-274-7720

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

Provider Enumeration Date	:	03/27/2017
Last Update Date	:	04/05/2022

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