Provider Demographics
NPI:1770457707
Name:ABDUL MALIK, ARAFAT SR
Entity type:Individual
Prefix:
First Name:ARAFAT
Middle Name:
Last Name:ABDUL MALIK
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6325 W MEDLOCK DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-7212
Mailing Address - Country:US
Mailing Address - Phone:623-522-2194
Mailing Address - Fax:
Practice Address - Street 1:6325 W MEDLOCK DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-7212
Practice Address - Country:US
Practice Address - Phone:623-522-2194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDLNK96501650171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter