Provider Demographics
NPI:1679534630
Name:MALIK, ARIF M (MD)
Entity type:Individual
Prefix:
First Name:ARIF
Middle Name:M
Last Name:MALIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:RAVENSWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26164
Mailing Address - Country:US
Mailing Address - Phone:304-273-2614
Mailing Address - Fax:304-273-2599
Practice Address - Street 1:316 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RAVENSWOOD
Practice Address - State:WV
Practice Address - Zip Code:26164-1704
Practice Address - Country:US
Practice Address - Phone:304-273-2614
Practice Address - Fax:304-273-2636
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV19979207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1000272000Medicaid
H46612Medicare UPIN
WV1000272000Medicaid
WV4058375Medicare PIN