Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 4301502960 | MI |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 4301502960 | MI |
NPI | 1225567944 |
---|---|
Provider Name | Dr. Bilal Tarek Malek |
First Address | Southfield, MI 48075-4818 |
Second Address | Southfield, MI 48075-4818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2017 |
Last Update Date | 23/06/2021 |