Organization Active NPI

Michael E Abdul-Malak, MD, LLC

  • Obstetrics & Gynecology Physician
  • Hermitage, PA
National Provider Identifier
1407974868
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD052122L Issued in PA
Legal business name
MICHAEL E ABDUL-MALAK, MD, LLC
Practice address
2151 Shenango Valley Fwy Ste a-2
Hermitage, PA 16148
Phone
(724) 347-4561
Fax
(724) 347-4566
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael E Abdul-Malak, MD
Title
President
Phone
(724) 347-4561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X MD052122L PA Primary

Addresses

Primary practice location

2151 Shenango Valley Fwy Ste a-2
Hermitage, PA 16148

Mailing address

PO Box 1318
Hermitage, PA 16148-0318
Phone (724) 347-4561

Other practice location 1

875 N Hermitage Rd
Suite # 1
Hermitage, PA 16148-3278
Phone (724) 347-4561

Other practice location 2

875 N Hermitage Rd
Suite # 1
Hermitage, PA 16148-3278
Phone (724) 347-4561

Other identifiers 1

IdentifierTypeStateIssuer
14684240005MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548633600000",
    "number": "1407974868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1318",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161480318",
            "telephone_number": "724-347-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 SHENANGO VALLEY FWY STE A-2",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "16148",
            "telephone_number": "724-347-4561",
            "fax_number": "724-347-4566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 N Hermitage Rd",
            "address_2": "Suite # 1",
            "address_purpose": "LOCATION",
            "city": "Hermitage",
            "state": "PA",
            "postal_code": "161483278",
            "country_code": "US",
            "telephone_number": "724-347-4561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "875 N Hermitage Rd",
            "address_2": "Suite # 1",
            "address_purpose": "LOCATION",
            "city": "Hermitage",
            "state": "PA",
            "postal_code": "161483278",
            "country_code": "US",
            "telephone_number": "724-347-4561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHAEL E ABDUL-MALAK, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2019-01-28",
        "status": "A",
        "authorized_official_last_name": "ABDUL-MALAK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-347-4561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD052122L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14684240005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.