Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD035345E | PA |
NPI | 1699730572 |
---|---|
Provider Name | Dr. Khalil Mahmood Malik |
First Address | North Wales, PA 19454-1921 |
Second Address | Lansdale, PA 19446-5338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1047825 | (05) | PA |
D71624 | (02) | PA |