Provider Demographics
NPI:1730790437
Name:MALIK, MUHAMMAD WALEED (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:WALEED
Last Name:MALIK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10206 MAPLE TREE LN
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1681
Mailing Address - Country:US
Mailing Address - Phone:516-413-9276
Mailing Address - Fax:
Practice Address - Street 1:37 S BROAD ST
Practice Address - Street 2:
Practice Address - City:PAWCATUCK
Practice Address - State:CT
Practice Address - Zip Code:06379-7909
Practice Address - Country:US
Practice Address - Phone:860-599-4030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0015089183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist