Individual
NOMAN AHMED MALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 890-3500
Mailing address
PO BOX 2876, MOULTRIE, GA 31776-2876
(229) 891-9131
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101232064
VA
2085R0202X
Diagnostic Radiology Physician
Primary
060004
GA
2085R0204X
Vascular & Interventional Radiology Physician
060004
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
721951141A
—
GA
05
—
721951141B
—
GA
01
—
P00656844
RAILROAD MEDICARE
GA
Enumeration date
07/11/2006
Last updated
12/05/2023
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