Individual
MATTHEW RICHARD MALIVUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
44045 RIVERSIDE PKWY, LEESBURG, VA 20176-5101
(703) 858-6000
(703) 858-6900
Mailing address
2215 LANDOVER PL, LYNCHBURG, VA 24501-2115
(434) 947-3944
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0102203666
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487910725
—
VA
Enumeration date
04/10/2012
Last updated
02/15/2023
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