Provider Demographics
NPI:1972051530
Name:MICHAEL ABDUL-MALEK DO PLLC
Entity type:Organization
Organization Name:MICHAEL ABDUL-MALEK DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDUL-MALEK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:313-485-7545
Mailing Address - Street 1:1380 COOLIDGE HWY STE 250
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-7067
Mailing Address - Country:US
Mailing Address - Phone:248-288-1117
Mailing Address - Fax:
Practice Address - Street 1:1380 COOLIDGE HWY STE 250
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-7067
Practice Address - Country:US
Practice Address - Phone:248-288-1117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017305207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty