Individual
IFTIKHAR A MALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 E CAPITOL DR, APPLETON, WI 54911-8735
(920) 358-1223
(920) 358-1224
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3298
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
48034
WI
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
48034
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34636400
—
WI
01
—
P00234590
RR MEDICARE
—
Enumeration date
07/07/2006
Last updated
07/21/2010
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