SHAHAB A MALIK MD, LLC.
NPI 1740329507
Pediatrics in Glen Burnie, MD

Active since February 06, 2007CLIA 21D2152910 · Waiver
1403 MADISON PARK DR STE 100, GLEN BURNIE, MD 21061(410) 582-9630(410) 582-9653 Get Directions Write a Review

NPPES record last updated: August 14, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 14, 2024, Aug 22, 2020 (2 updates tracked since 2020).

About Shahab A Malik Md, Llc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAHAB A MALIK MD, LLC. (NPI 1740329507) is a healthcare organization registered as a pediatrics in Glen Burnie, Maryland and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through August 19, 2026 and lists Shahab Asghar Malik, Chairman, as its authorized official.

NPPES Registry Identity

NPI1740329507
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameSHAHAB A MALIK MD, LLC.
Location Address1403 MADISON PARK DR STE 100Glen Burnie, MD 21061-6292
Mailing Address1403 Madison Park Dr Ste 100Glen Burnie, MD 21061-6292 · (410) 582-9630 · Fax (410) 582-9653
Fax(410) 582-9653
Organization SubpartNo
Authorized OfficialShahab Asghar MalikChairman · (410) 582-9630
Enumeration DateFebruary 6, 2007
Last NPPES UpdateAugust 14, 20242 updates tracked since enumeration
NPPES CertifiedAugust 14, 2024
NPI 1740329507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1403 MADISON PARK DR STE 100, Glen Burnie, MD 21061

Other Identifiers 1

Medicaid698105400MD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
21D2152910
Facility Type
Physician Office
Certificate Effective Date
August 20, 2024
Certificate Expiration Date
August 19, 2026
Laboratory Director
SHAHAB A. MALIK MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Shahab A Malik Md, Llc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Nurse Practitioner (Pediatrics)
1403 MADISON PARK DR STE 100
GLEN BURNIE, MD 21061
Pediatrics (Neonatal-Perinatal Medicine)
1403 MADISON PARK DR STE 100
GLEN BURNIE, MD 21061

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1740329507, enumerated as an "organization" on February 06, 2007.

The provider is located at 1403 MADISON PARK DR STE 100 GLEN BURNIE, MD 21061 and the phone number is (410) 582-9630.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.