MEDICARE: EVGENIA MALIK PA

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	363A00000X	Physician Assistant	0110007754	VA

General Provider Information

NPI Number	:	1962913368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVGENIA MALIK PA

Provider Business Mailing Address
First Line	:	1920 BALLENGER AVE STE 107
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-6913
Country	:	US
Telephone Number	:	703-214-4628
Fax Number	:	703-810-5452

Provider Business Practice Location Address
First Line	:	1920 BALLENGER AVE STE 107
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-6913
Country	:	US
Telephone Number	:	703-214-4628
Fax Number	:	703-810-5452

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

Provider Enumeration Date	:	10/12/2017
Last Update Date	:	04/07/2026

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Directions to “ EVGENIA MALIK PA” Practice Location

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