Healthcare Provider Details

I. General information

NPI: 1699686584
Provider Name (Legal Business Name): SUMBEL MALIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 WILSON BLVD
ROSSLYN VA
22209-2458
US

IV. Provider business mailing address

11209 WHITHORN WAY
ELLICOTT CITY MD
21042-6141
US

V. Phone/Fax

Practice location:
  • Phone: 571-777-2439
  • Fax:
Mailing address:
  • Phone: 410-349-6298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202222438
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: