Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 63741 | WI |
Y | 207RP1001X | Pulmonary Disease | 63741 | WI |
NPI | 1083628226 |
---|---|
Provider Name | Amy N. Malik |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02674500 | (05) | NY |
I43074 | (02) | NY |