Healthcare Provider Details

I. General information

NPI: 1578096111
Provider Name (Legal Business Name): DARYA KOENIG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DARYA MALININA MD

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 EASTERN AVE
BALTIMORE MD
21224-2734
US

IV. Provider business mailing address

2500 LEGACY DR STE 200
FRISCO TX
75034-1844
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-3350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number0101277998
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101277998
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: