Organization
AMIR G ABDELMALIK MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMIR G ABDELMALIK MD (PHYSICIAN / OWNER)
(917) 757-8549
Entity
Organization
Contact information
Practice address
6711 S YALE AVE STE 104, TULSA, OK 74136-3317
(918) 522-7200
(918) 522-7201
Mailing address
14024 ROSE LODGE PL, CHANTILLY, VA 20151-2247
(917) 757-8549
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
28935
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200419510A
—
OK
Enumeration date
07/24/2017
Last updated
04/30/2018
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