Provider Demographics
NPI:1144477951
Name:ELMALIK, HASSAN (MD)
Entity type:Individual
Prefix:DR
First Name:HASSAN
Middle Name:
Last Name:ELMALIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11455 N MERIDIAN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1624
Mailing Address - Country:US
Mailing Address - Phone:317-582-8180
Mailing Address - Fax:317-582-8185
Practice Address - Street 1:11455 N MERIDIAN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1624
Practice Address - Country:US
Practice Address - Phone:317-582-8180
Practice Address - Fax:317-582-8185
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01074057A207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201228340Medicaid
IN207RI0200XOtherTAXONOMY CODE
IN1144477951Medicare PIN
IN095700005Medicare UPIN