Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | MD-37402 | IA |
N | 207RC0000X | Internist - Cardiovascular Disease | 37402 | IA |
NPI | 1457553653 |
---|---|
Provider Name | Mudassir Ilyas Malik |
First Address | Des Moines, IA 50306-9170 |
Second Address | Des Moines, IA 50314-3029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 15/06/2020 |