Provider Demographics
NPI:1699761056
Name:MALEK, FADI YOSEF (MD FCCP)
Entity type:Individual
Prefix:
First Name:FADI
Middle Name:YOSEF
Last Name:MALEK
Suffix:
Gender:M
Credentials:MD FCCP
Other - Prefix:
Other - First Name:FADI
Other - Middle Name:YUSSEF
Other - Last Name:MALEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD FCCP
Mailing Address - Street 1:227 BENDEL RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2903
Mailing Address - Country:US
Mailing Address - Phone:337-232-5864
Mailing Address - Fax:337-234-6887
Practice Address - Street 1:227 BENDEL RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2903
Practice Address - Country:US
Practice Address - Phone:337-232-5864
Practice Address - Fax:337-234-6887
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11796R207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1687600Medicaid
LA5Y1887711Medicare PIN
LAG39813Medicare UPIN