Individual
GHAZALA SADRUDDIN MALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
630 EATON AVE, HAMILTON, OH 45013-2767
(513) 867-2270
(513) 867-2581
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35.070914
OH
207R00000X
Internal Medicine Physician
35070914M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000317069
BCBS
OH
05
—
0381680
—
OH
01
—
P00074637
RAIL ROAD MEDICARE
—
Enumeration date
05/04/2006
Last updated
12/15/2020
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