Healthcare Provider Details

I. General information

NPI: 1922780535
Provider Name (Legal Business Name): BARY MANA MALIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 N ELM ST
HENDERSON KY
42420-2783
US

IV. Provider business mailing address

8560 2ND AVE APT 615
SILVER SPRING MD
20910-6305
US

V. Phone/Fax

Practice location:
  • Phone: 270-827-7700
  • Fax:
Mailing address:
  • Phone: 240-354-6775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMTL-600001705
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number62106
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: