Individual
MALEK MAATOUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1225 E COOLSPRING AVE, MICHIGAN CITY, IN 46360-6312
(219) 878-5054
(219) 878-5053
Mailing address
1225 E COOLSPRING AVE, MICHIGAN CITY, IN 46360-6312
(219) 878-5054
(219) 878-5053
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01060123A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000369964
ANTHEM
IN
05
—
200509930
—
IN
01
—
P00286172
MEDICARE RR
—
Enumeration date
01/28/2006
Last updated
08/09/2011
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