Individual
DR. AMEEN ABDULMALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
465 N TELEGRAPH RD, MONROE, MI 48162-3334
(734) 242-8880
(734) 384-0139
Mailing address
15150 FORT ST, SOUTHGATE, MI 48195-1302
(734) 282-4800
(734) 282-9302
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
4301078156
MI
207RI0011X
Interventional Cardiology Physician
Primary
4301078156
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11783199
CAQH
MI
01
—
1578767950
BCBS TYPE 1 NPI
MI
05
—
1578767950
—
MI
01
—
4301078156
STATE LICENSE #
MI
01
—
AA078156
MI STATE MEDICAL LICENSE
MI
Enumeration date
06/12/2007
Last updated
05/19/2025
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