Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 036-105013 | IL |
NPI | 1023128212 |
---|---|
Provider Name | Saeeda K. Malik |
First Address | Dothan, AL 36302-1928 |
Second Address | Dothan, AL 36301-3022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 01/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036105013 | (05) | IL |
137794 | (05) | AL |
H83400 | (02) | IL |