Malik, Imtiaz A
Malik, Imtiaz A is an individual health care provider with primary practice located at 2400 Unser Blvd Se , Rio Rancho NM 87124-4740. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Malik, Imtiaz A can be contacted via phone (505) 559-6100.Contact Information
Primary practice address
2400 Unser Blvd Se
Rio Rancho NM 87124-4740
Phone: (505) 559-6100
Fax: (505) 559-6101
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA2002-0028 | New Mexico |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA2002-0028 | New Mexico |
Profile Details
| NPI number | 1356322762 |
|---|---|
| LBN Legal business name | Malik, Imtiaz A |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 11th, 2005 |
| Last updated | Mar 17th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356322762 | NPPES |
| New Mexico | MEDICAID | 32486006 |
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