Healthcare Provider Details

I. General information

NPI: 1336778067
Provider Name (Legal Business Name): ASHWINI GADALAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2020
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 TATE SPRINGS RD
LYNCHBURG VA
24501-1109
US

IV. Provider business mailing address

2025 TATE SPRINGS RD STE B1
LYNCHBURG VA
24501-1116
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-3600
  • Fax:
Mailing address:
  • Phone: 434-200-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number0101282651
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: