Provider Demographics
NPI:1386902104
Name:ANJUM, MALIK ASAD (MD)
Entity type:Individual
Prefix:DR
First Name:MALIK
Middle Name:ASAD
Last Name:ANJUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4445 CORPORATION LN STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3666
Mailing Address - Country:US
Mailing Address - Phone:757-623-0005
Mailing Address - Fax:757-548-1129
Practice Address - Street 1:301 RIVERVIEW AVE STE 512
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510
Practice Address - Country:US
Practice Address - Phone:757-623-0005
Practice Address - Fax:757-389-5774
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101262154207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty