Provider Demographics
NPI:1992788806
Name:MALEK, MEHRDAD M (MD)
Entity type:Individual
Prefix:MR
First Name:MEHRDAD
Middle Name:M
Last Name:MALEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8316 ARLINGTON BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5216
Mailing Address - Country:US
Mailing Address - Phone:703-641-5633
Mailing Address - Fax:703-289-1273
Practice Address - Street 1:8316 ARLINGTON BLVD
Practice Address - Street 2:STE 414
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5207
Practice Address - Country:US
Practice Address - Phone:703-641-5633
Practice Address - Fax:703-821-5633
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101030924207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0900955OtherUNITED HEALTHCARE OF MID
DC15690001OtherCAREFIRST BLUE SHIELD DC
504164OtherAETNA HMO
MD0900045OtherUNITED HEALTHCARE OF NORT
MD0900129OtherUNITED HEALTHCARE OF MID
MD34037504OtherCAREFIRST MARYLAND
VA0900046OtherUNITED HEALTHCARE OF NORT
145854900OtherWORKMANS COMP US DEPT
IL456840OtherMEDICARE GROUP
MD070336OtherANTHEM BLUE SHIELD
VA34037503OtherCAREFIRST MARYLAND
4053030OtherAETNA PPO
VA021800OtherANTHEM BLUE SHIELD
IL036107945Medicaid
ILK48233Medicare PIN
4053030OtherAETNA PPO
VA0900955OtherUNITED HEALTHCARE OF MID