Provider Demographics
NPI:1649938069
Name:MALIK, ANTHONY C A (DPT)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:C A
Last Name:MALIK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3785 MAPLECREST DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21758-9118
Mailing Address - Country:US
Mailing Address - Phone:240-397-4092
Mailing Address - Fax:
Practice Address - Street 1:3785 MAPLECREST DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:MD
Practice Address - Zip Code:21758-9118
Practice Address - Country:US
Practice Address - Phone:240-397-4092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28785225100000X
2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic