Provider Demographics
NPI:1992784706
Name:MALIK, FIRASAT S (MD)
Entity type:Individual
Prefix:MR
First Name:FIRASAT
Middle Name:S
Last Name:MALIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:# L-2329
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43260-2329
Mailing Address - Country:US
Mailing Address - Phone:304-205-8906
Mailing Address - Fax:304-345-7320
Practice Address - Street 1:2335 CHESTERFIELD AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1066
Practice Address - Country:US
Practice Address - Phone:304-343-7576
Practice Address - Fax:304-343-3273
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV14371208G00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1942385950OtherGROUP MEDICAID
WV330001114OtherRR MEDICARE
WV9154261OtherGROUP MEDICARE
WV0129472000Medicaid
WV9154261OtherGROUP MEDICARE
WV0129472000Medicaid