Basic Information
Provider Information
NPI: 1376651273
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WASEEM
FirstName: MALIKA
MiddleName: F.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5525 RESEARCH PARK DR FL 4
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212284873
CountryCode: US
TelephoneNumber: 4108823240
FaxNumber: 4106615093
Practice Location
Address1: 8800 WALTHER BLVD
Address2:  
City: BALTIMORE
State: MD
PostalCode: 21234
CountryCode: US
TelephoneNumber: 4108823240
FaxNumber: 4106615093
Other Information
ProviderEnumerationDate: 08/29/2006
LastUpdateDate: 03/25/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XD38754MDY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
E31401MDBLUECHOICE #OTHER
76578110005MD MEDICAID
11006082201MDRAILROAD MEDICARE #OTHER
9974MF01MDCAREFIRST MARYLAND #OTHER


Home