MEDICARE: ASHA KRISHNA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0805X	Geriatric Psychiatry Physician	0116020077	VA

General Provider Information

NPI Number	:	1487845863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHA KRISHNA MD

Provider Business Mailing Address
First Line	:	2118 ROSALIND AVENUE
Second Line	:	CARILION CLINIC
City	:	ROANOKE
State	:	VA
Zip	:	24014
Country	:	US
Telephone Number	:	540-981-7653
Fax Number	:

Provider Business Practice Location Address
First Line	:	2118 ROSALIND AVENUE
Second Line	:	CARILION CLINIC
City	:	ROANOKE
State	:	VA
Zip	:	24014
Country	:	US
Telephone Number	:	540-981-7653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2007
Last Update Date	:	06/24/2008

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