Provider Demographics
NPI:1538361423
Name:MALIK, KHURRAM JAVED (MD)
Entity type:Individual
Prefix:DR
First Name:KHURRAM
Middle Name:JAVED
Last Name:MALIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6400 ARLINGTON BLVD.
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2349
Mailing Address - Country:US
Mailing Address - Phone:703-288-9001
Mailing Address - Fax:703-288-5169
Practice Address - Street 1:6400 ARLINGTON BLVD.
Practice Address - Street 2:SUITE 600
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2349
Practice Address - Country:US
Practice Address - Phone:703-288-9001
Practice Address - Fax:703-288-5169
Is Sole Proprietor?:No
Enumeration Date:2007-06-03
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN49565207W00000X
CT046486207W00000X
MDD0069193207W00000X
VA0101242539207W00000X, 207WX0107X, 207WX0108X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207WX0108XAllopathic & Osteopathic PhysiciansOphthalmologyUveitis and Ocular Inflammatory Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1538361423Medicaid
MD0237183 00Medicaid
DC056773200Medicaid
MD023718301Medicaid
MD023718301Medicaid
VA168064ZUBBMedicare PIN