Provider Demographics
NPI:1144986969
Name:UMAIR MOIZ MALIK MD PC
Entity type:Organization
Organization Name:UMAIR MOIZ MALIK MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UMAIR
Authorized Official - Middle Name:MOIZ
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-384-4100
Mailing Address - Street 1:3149 LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:THORNDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19372-1129
Mailing Address - Country:US
Mailing Address - Phone:610-384-4100
Mailing Address - Fax:610-441-7588
Practice Address - Street 1:3149 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:THORNDALE
Practice Address - State:PA
Practice Address - Zip Code:19372-1129
Practice Address - Country:US
Practice Address - Phone:610-384-4100
Practice Address - Fax:610-441-7588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA256083OtherMEDICARE