MEDICARE: DR. ANUJ MALIK

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	122300000X	Dentist	DN25478	FL
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1558653337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANUJ MALIK

Provider Business Mailing Address
First Line	:	3012 W SIGNATURE DR APT 1303
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-6456
Country	:	US
Telephone Number	:	646-824-8264
Fax Number	:

Provider Business Practice Location Address
First Line	:	4461 SHERIDAN ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3513
Country	:	US
Telephone Number	:	954-966-6352
Fax Number	:

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

Provider Enumeration Date	:	05/11/2011
Last Update Date	:	10/19/2020

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Directions to “ DR. ANUJ MALIK ” Practice Location

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