Individual
TILAK KUMAR MALLIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 MEDICAL CENTER BLVD, SUITE S 113, MARRERO, LA 70072-3151
(504) 349-6520
(504) 349-6522
Mailing address
1111 MEDICAL CENTER BLVD, SUITE S113, MARRERO, LA 70072-3151
(504) 349-6520
(504) 349-6522
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
04776R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1317926
—
LA
Enumeration date
08/10/2006
Last updated
03/21/2018
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