Healthcare Provider Details

I. General information

NPI: 1306138318
Provider Name (Legal Business Name): NAIMA MALIK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2011
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17739 MAIN ST
DUMFRIES VA
22026-3251
US

IV. Provider business mailing address

1402 GOWER CT
MC LEAN VA
22102-2732
US

V. Phone/Fax

Practice location:
  • Phone: 703-680-7950
  • Fax:
Mailing address:
  • Phone: 571-564-8616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101284903
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: