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General NPI Number Information
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NPI Number | 1215470133
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Entity Type | Individual
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Provider Name | SADIATU MALIKE
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Gender | Female
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Dates
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Enumeration Date | 11/25/2016
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 5845 RICHMOND HWY STE 150
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City | ALEXANDRIA
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State | VA
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Zip | 22303-1868
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Country | US
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Telephone | 703-538-2065
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Fax |
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Provider Business Mailing Address
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Address Line | 8319 DUCK HAWK WAY
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City | LORTON
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State | VA
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Zip | 22079-2825
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Country | US
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Telephone | 703-870-0979
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024174208
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License Number State | VA
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