MEDICARE: RAJUL MALIK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	0101237082	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	181490	OTHER	VA	ANTHEM
2	99624	OTHER	VA	SENTARA/OPTIMA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	541595397	OTHER	VA	MID ATLANTIC SOLUTIONS
5	5559560	OTHER	VA	AETNA

General Provider Information

NPI Number	:	1376517607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJUL MALIK MD

Provider Business Mailing Address
First Line	:	3241 WESTERN BRANCH BLVD
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23321-5260
Country	:	US
Telephone Number	:	757-686-3508
Fax Number	:	757-686-0541

Provider Business Practice Location Address
First Line	:	1168 FIRST COLONIAL RD
Second Line	:	SUITE 201
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-2426
Country	:	US
Telephone Number	:	757-481-1113
Fax Number	:	757-496-3822

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	04/12/2010

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