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Individual

SAFIULLAH M MALIK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD FACS

Contact information

Practice address
2223 W STATE ST, SUITE 109, OLEAN, NY 14760-1938
(716) 372-3474
(716) 372-4370
Mailing address
2223 W STATE ST, SUITE 109, OLEAN, NY 14760-1938
(716) 372-3474
(716) 372-4370

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
1584811
NY
2086S0129X
Vascular Surgery Physician
1584811
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000500459D01
COMMUNITY BLUE
NY
05
00891603
NY
01
10109701
UNIVERA
NY
Enumeration date
10/17/2006
Last updated
12/26/2012
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