Individual
GUNWANT S MALLIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 HIDDEN RAVINES DR, POWELL, OH 43065-9883
(614) 942-0132
(614) 942-0139
Mailing address
10169 WELLINGTON BLVD, POWELL, OH 43065-7671
(614) 942-0132
(614) 942-0139
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
35070094
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000518235
BLUE CROSS/BLUE SHIELD
OH
05
—
0225723
—
OH
01
—
208005968
AETNA
OH
01
—
208005968026
CARESOURCE
OH
Enumeration date
12/01/2005
Last updated
07/24/2024
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