Mallick, Mohammad S

Mallick, Mohammad S is an sole proprietor health care provider with primary practice located at 1525 Liberty Ct , Brookfield WI 53045-5327. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Mallick, Mohammad S can be contacted via phone (262) 646-6280.

Contact Information

Primary practice address
1525 Liberty Ct Brookfield WI 53045-5327
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 27719 Wisconsin

Profile Details

NPI number 1689607798
LBN Legal business name Mallick, Mohammad S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 9th, 2006
Last updated Oct 17th, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689607798 NPPES
Wisconsin MEDICAID 31466300

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