Provider Demographics
NPI:1841364908
Name:MALIK, ZULFIQAR A (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ZULFIQAR
Middle Name:A
Last Name:MALIK
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 ROSELANE ST NW STE 710
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6975
Mailing Address - Country:US
Mailing Address - Phone:678-331-3297
Mailing Address - Fax:678-581-7187
Practice Address - Street 1:340 KENNESTONE HOSPITAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1158
Practice Address - Country:US
Practice Address - Phone:770-281-5100
Practice Address - Fax:678-581-7100
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286865207RH0003X
TXM1221207RH0003X
GA91031207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200884400Medicaid
KY50015854OtherPASSPORT
KY7100012090Medicaid
KYP00688327OtherRR MEDICARE
GA1841364908OtherNPI NUMBER
TX176708901Medicaid
I41897Medicare UPIN
8D9859Medicare UPIN
IN630960TMedicare PIN
KY0299039Medicare PIN