Individual
FOUAD MALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4615 EASTMAN AVE, MIDLAND, MI 48640-2610
(989) 631-7110
Mailing address
12100 DIX TOLEDO RD, SOUTHGATE, MI 48195-3531
(989) 892-7722
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005743
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5560044
BCBS GROUP
MI
Enumeration date
09/15/2010
Last updated
03/17/2020
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