Individual
PRAMOD MALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3910 BRIDGE RD STE 101, SUFFOLK, VA 23435-1107
(757) 942-2566
(855) 313-1070
Mailing address
3910 BRIDGE RD STE 101, SUFFOLK, VA 23435-1107
(757) 942-2566
(855) 313-1070
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0101231641
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010103061
—
VA
01
—
159847
ANTEM OF VA
VA
Enumeration date
12/21/2005
Last updated
05/11/2020
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