Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 5901002587 | MI |
NPI | 1053794859 |
---|---|
Provider Name | Dr. Ali Malik |
First Address | Detroit, MI 48202-3450 |
Second Address | Detroit, MI 48202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2015 |
Last Update Date | 29/06/2018 |