Healthcare Provider Details

I. General information

NPI: 1629134291
Provider Name (Legal Business Name): ASHA VALI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9801 GEORGIA AVE STE 118
SILVER SPRING MD
20902-5276
US

IV. Provider business mailing address

12013 BROAD MEADOW LN
CLARKSVILLE MD
21029-1258
US

V. Phone/Fax

Practice location:
  • Phone: 301-284-8909
  • Fax: 410-891-5424
Mailing address:
  • Phone: 410-531-9717
  • Fax: 410-531-5803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberD0052861
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: