Provider Demographics
NPI:1144484916
Name:ESTEMALIK, EMAD N (MD)
Entity type:Individual
Prefix:DR
First Name:EMAD
Middle Name:N
Last Name:ESTEMALIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12550 LAKE AVE
Mailing Address - Street 2:APPARTMENT 312
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-1575
Mailing Address - Country:US
Mailing Address - Phone:216-712-4615
Mailing Address - Fax:
Practice Address - Street 1:12550 LAKE AVE
Practice Address - Street 2:APPARTMENT 312
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-1575
Practice Address - Country:US
Practice Address - Phone:216-712-4615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.0143422084P0804X
OH35.0956382084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry