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NPI Code Detail

MEDICARE: MS. SHAMSAH MALIK NP

MEDICARE: MS. SHAMSAH MALIK NP
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
1363L00000XNurse PractitionerNP16673CA
2363LA2100XAcute Care Nurse Practitioner16673CA
3363LA2100XAcute Care Nurse PractitionerRN328032GA

General Provider Information

NPI Number : 1972711836
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHAMSAH MALIK NP
Provider Business Mailing Address
First Line : 1020 WHITEHAWK TRL
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30043-4193
Country : US
Telephone Number : 310-266-7270
Fax Number :
Provider Business Practice Location Address
First Line : 2878 FIVE FORKS TRICKUM RD
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30044-5896
Country : US
Telephone Number : 678-344-8700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 04/21/2025

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