Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 0101237904 | VA |
N | 2081P2900X | Pain Medicine | 213-450 | MA |
N | 2081P2900X | Pain Medicine | A84906 | CA |
Y | 2081P2900X | Pain Medicine | D0060663 | MD |
NPI | 1386631869 |
---|---|
Provider Name | Dr. Atif Babar Malik |
First Address | Germantown, MD 20875-2348 |
Second Address | Germantown, MD 20876-7022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 16/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
163049 | MEDICARE PTAN (01) | MD |
184393 | MEDICARE PTAN (01) | DC |
402627600 | (05) | MD |
H93783 | (02) | MD |