Individual
EBAAD MALICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6201 CENTREVILLE RD STE 200, CENTREVILLE, VA 20121-2626
(571) 549-8577
(571) 549-8578
Mailing address
PO BOX 791775, BALTIMORE, MD 21279-1775
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101275185
VA
207Q00000X
Family Medicine Physician
MT221644
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
03/25/2019
Last updated
04/26/2026
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