Provider Demographics
NPI:1841581295
Name:ISKANDAR, MALAK WAHEB YOSSEF (DO)
Entity Type:Individual
Prefix:DR
First Name:MALAK
Middle Name:WAHEB YOSSEF
Last Name:ISKANDAR
Suffix:
Gender:M
Credentials:DO
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 20867
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0526
Mailing Address - Country:US
Mailing Address - Phone:540-427-7944
Mailing Address - Fax:540-427-7945
Practice Address - Street 1:3959 ELECTRIC RD STE 280
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4572
Practice Address - Country:US
Practice Address - Phone:540-427-7944
Practice Address - Fax:540-427-7945
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01022039912084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry