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Individual

SHAHID NASIR MALIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
33-57 HARRISON ST, JOHNSON CITY, NY 13790-2107
(607) 763-6622
(607) 763-5064
Mailing address
346 GRAND AVE, JOHNSON CITY, NY 13790-2580
(607) 729-8156
(607) 763-3982

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101236201
VA
207R00000X
Internal Medicine Physician
242672
NY
208M00000X
Hospitalist Physician
Primary
074862
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02838728
NY
Enumeration date
07/20/2006
Last updated
10/02/2019
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