Provider Demographics
NPI:1386631869
Name:MALIK, ATIF BABAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ATIF
Middle Name:BABAR
Last Name:MALIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2348
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20875-2348
Mailing Address - Country:US
Mailing Address - Phone:240-629-3912
Mailing Address - Fax:
Practice Address - Street 1:20680 SENECA MEADOWS PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7022
Practice Address - Country:US
Practice Address - Phone:240-629-3926
Practice Address - Fax:240-629-3927
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00606632081P2900X
VA01012379042081P2900X
CAA849062081P2900X
MA213-4502081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD163049OtherMEDICARE PTAN
MD402627600Medicaid
DC184393OtherMEDICARE PTAN
MDH93783Medicare UPIN
MDBM7924598OtherFEDERAL DEA