Provider Demographics
NPI:1730442203
Name:MALIK, MOKERRUM FATIMA (MD)
Entity type:Individual
Prefix:DR
First Name:MOKERRUM
Middle Name:FATIMA
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:013-440-8339
Mailing Address - Fax:
Practice Address - Street 1:8171 MAPLE LAWN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2527
Practice Address - Country:US
Practice Address - Phone:410-531-7557
Practice Address - Fax:410-531-0818
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0091851207V00000X
MI4301101309207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology