Individual
MALIK F. FUIMAONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 E. KINCAID STREET, MOUNT VERNON, WA 98274
(360) 416-5750
(360) 416-5758
Mailing address
1400 E. KINCAID STREET, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60095480
WA
208M00000X
Hospitalist Physician
MD60095480
WA
208M00000X
Hospitalist Physician
MD6009580
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
263620
LABOR & INDUSTRIES
WA
Enumeration date
07/23/2009
Last updated
11/09/2010
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