Individual
DR. ABID K. MALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 N WEBB RD, WICHITA, KS 67226-8127
(316) 686-5300
(316) 651-2660
Mailing address
3535 N WEBB RD, WICHITA, KS 67226-8127
(316) 686-5300
(316) 651-2660
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
04-30084
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200380900J
—
KS
01
—
KA3651004
MEDICARE
KS
Enumeration date
05/27/2006
Last updated
02/01/2019
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