Individual provider · Type 1 NPI
Shaunn Dominique Malaka, DPM
Foot & Ankle Surgery Podiatrist · Woodbridge, VA
NPI number
1770724148
Active
Practice location
14904 Jefferson Davis Hwy, Ste 105
Woodbridge, VA 22191-3908
Fax (703) 490-8172
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 684 (CO) |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 01481 (MD) |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PO1000072 (DC) |
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | 0103301025 (VA) |
Foot & Ankle Surgery Podiatrist: Definition to come...
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About NPI 1770724148
Shaunn Dominique Malaka, DPM's National Provider Identifier is 1770724148, issued on Mar 16, 2009. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Woodbridge, VA. The record was last updated on Jan 11, 2018.