Look up the most recent NPI and PECOS records

Malik Mcmullin

Internal Medicine

Allopathic & Osteopathic Physicians

550 S Jackson St # A3k00, Louisville, KY 40202-1622

PECOS Enrollment

Based on the most recent information from CMS, provider Malik Mcmullin is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1447889035
Provider Type
Individual
Full Name
Mcmullin, Malik
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
4/6/2020
Last Updated
5/21/2024

Contact Information

Practice Location

550 S Jackson St # A3k00, Louisville, KY 40202-1622

(502) 852-4277

Unlisted Fax

Mailing Location

550 S Jackson St # A3k00, Louisville, KY 40202-1622

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 58925 Kentucky
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer
Code 208000000X	Description Pediatrics Allopathic & Osteopathic Physicians	License R5358 Kentucky

Malik Mcmullin

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Philip J. Feitelson, M.D. Psc

Hammudeh, Yousef

Louisville Medical Associates

Sharpe, Tyler Daniel

Dillon, John

Paradowski, Brian Joseph

Houghland, Stephen

Ivy, Kendra Nadine

Gerlach, Dylan Nathanael

Parikh, Ishan