Provider Demographics
NPI:1427491174
Name:MALIK, ZEESHAN (DO)
Entity type:Individual
Prefix:
First Name:ZEESHAN
Middle Name:
Last Name:MALIK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 S CRISMON RD STE 188
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-3900
Mailing Address - Country:US
Mailing Address - Phone:480-900-7373
Mailing Address - Fax:480-900-6844
Practice Address - Street 1:1810 S CRISMON RD STE 188
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3900
Practice Address - Country:US
Practice Address - Phone:480-900-7373
Practice Address - Fax:480-900-6844
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-12
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ007579207LP2900X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program