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Individual

DR. SHAISTA MALIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10000 ZANE AVE N, BROOKLYN PARK, MN 55443-1400
(763) 528-6999
Mailing address
1700 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3727

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54505
MN
207Q00000X
Family Medicine Physician
ME102532
FL
2083P0901X
Public Health & General Preventive Medicine Physician
54505
MN
390200000X
Student in an Organized Health Care Education/Training Program
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ME102532
FLORIDA LICENSE
FL
Enumeration date
09/14/2006
Last updated
02/29/2024
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