Provider Demographics
NPI:1962575928
Name:MALIK, RUBEELA (MD)
Entity type:Individual
Prefix:DR
First Name:RUBEELA
Middle Name:
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 16TH AVE E
Mailing Address - Street 2:CSB 2, GASTRO
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5211
Mailing Address - Country:US
Mailing Address - Phone:206-326-3213
Mailing Address - Fax:206-326-2555
Practice Address - Street 1:125 16TH AVE E
Practice Address - Street 2:CSB 2, GASTRO
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5211
Practice Address - Country:US
Practice Address - Phone:206-326-3213
Practice Address - Fax:206-326-2555
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD29758207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8187023Medicaid
WA8187023Medicaid
WAA 99518Medicare UPIN
WAAB 23489Medicare ID - Type UnspecifiedSNOHMISH COUNTY