Provider Demographics
NPI:1124439336
Name:MALIK, SEEMAB NAZAR (MD)
Entity type:Individual
Prefix:MISS
First Name:SEEMAB
Middle Name:NAZAR
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:SEEMAB
Other - Middle Name:NAZAR
Other - Last Name:MALIK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1580 SANTA BARBARA BLVD
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-6827
Mailing Address - Country:US
Mailing Address - Phone:352-259-2159
Mailing Address - Fax:352-259-5731
Practice Address - Street 1:1580 SANTA BARBARA BLVD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159
Practice Address - Country:US
Practice Address - Phone:352-259-2159
Practice Address - Fax:352-259-5731
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290572207R00000X
FLME139422207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103606600Medicaid
FLLL038OtherMEDICARE