Individual
DR. OMAR IBN ABDUL-MALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
219 PEABODY ST NW, WASHINGTON, DC 20011-2215
(202) 549-7136
Mailing address
219 PEABODY ST NW, WASHINGTON, DC 20011-2215
(202) 545-0502
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-30201
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA-30201
PHYSICIAN ASSISTANT
DC
Enumeration date
06/05/2007
Last updated
04/16/2015
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