Provider Demographics
NPI:1568402600
Name:MALIK, RIZWAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:RIZWAN
Middle Name:A
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 1:517 SENECA RD
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-1116
Mailing Address - Country:US
Mailing Address - Phone:301-538-8151
Mailing Address - Fax:703-430-6579
Practice Address - Street 1:1497 CHAIN BRIDGE RD 103
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101
Practice Address - Country:US
Practice Address - Phone:301-538-8151
Practice Address - Fax:703-726-0042
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD328062084P0804X
VA01012313612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry