MEDICARE: DR. KHALID MASOOD MALIK 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
1	208600000X	Surgery Physician	041834	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0730003	OTHER		BCBSM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730173014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KHALID MASOOD MALIK MD

Provider Business Mailing Address
First Line	:	70 N FROST DR
Second Line	:	STE 1
City	:	SAGINAW
State	:	MI
Zip	:	48638-5796
Country	:	US
Telephone Number	:	989-792-4440
Fax Number	:	989-792-0685

Provider Business Practice Location Address
First Line	:	70 N FROST DR
Second Line	:	STE 1
City	:	SAGINAW
State	:	MI
Zip	:	48638-5796
Country	:	US
Telephone Number	:	989-792-4440
Fax Number	:	989-792-0685

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

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	03/19/2008

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