Healthcare Provider Details

I. General information

NPI: 1194384578
Provider Name (Legal Business Name): EMANUELA CRISTY PESHEL MD, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N NASH ST APT 241
ARLINGTON VA
22209-3688
US

IV. Provider business mailing address

1200 N NASH ST APT 241
ARLINGTON VA
22209-3688
US

V. Phone/Fax

Practice location:
  • Phone: 330-338-0636
  • Fax:
Mailing address:
  • Phone: 330-338-0636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.156592
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35.156592
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: