| Komal a Malik, MD | |
|
8315 Cherry Ln Laurel MD 20707-4830 | |
| (301) 604-7000 | |
| (301) 604-7005 |
| Full Name | Komal a Malik, MD |
|---|---|
| Speciality | Family Medicine |
| Location | 8315 Cherry Ln, Laurel, Maryland |
| Authorized Official Name and Position | Komal Anwar Malik (OWNER) |
| Authorized Official Contact | 3016047000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Komal a Malik, MD 8315 Cherry Ln Laurel MD 20707-4830 Ph: (301) 604-7000 | Komal a Malik, MD 8315 Cherry Ln Laurel MD 20707-4830 Ph: (301) 604-7000 |
| NPI Number | 1700215399 |
|---|---|
| Provider Enumeration Date | 11/05/2013 |
| Last Update Date | 11/05/2013 |
| Medicare PECOS PAC ID | 8527296748 |
|---|---|
| Medicare Enrollment ID | O20140116000236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700215399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D0067967 (Maryland) | Primary |
| Provider Name | Komal a Malik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730339995 PECOS PAC ID: 4486701547 Enrollment ID: I20120808000010 |
| Provider Name | Sana Tarapore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609497783 PECOS PAC ID: 3971073495 Enrollment ID: I20260526003759 |
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