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NPI Code Detail

MEDICARE: DR. ABID K. MALLICK MD

MEDICARE: DR. ABID K. MALLICK MD
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
1207RC0000XCardiovascular Disease Physician04-30084KS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2KA3651004OTHERKSMEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1538116488
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ABID K. MALLICK MD
Provider Business Mailing Address
First Line : 3535 N WEBB RD
Second Line :
City : WICHITA
State : KS
Zip : 67226-8127
Country : US
Telephone Number : 316-686-5300
Fax Number : 316-651-2660
Provider Business Practice Location Address
First Line : 3535 N WEBB RD
Second Line :
City : WICHITA
State : KS
Zip : 67226-8127
Country : US
Telephone Number : 316-686-5300
Fax Number : 316-651-2660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 02/01/2019

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