Healthcare Provider Details

I. General information

NPI: 1184033383
Provider Name (Legal Business Name): EMILY ASHLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2014
Last Update Date: 08/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 FOREST AVE SUITE 115
RICHMOND VA
23230-1729
US

IV. Provider business mailing address

13000 RIVERS BEND BLVD SUITE C
CHESTER VA
23836-8632
US

V. Phone/Fax

Practice location:
  • Phone: 804-893-8710
  • Fax: 804-285-1293
Mailing address:
  • Phone: 804-571-5000
  • Fax: 804-518-1314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101-246465
License Number StateVA

VIII. Authorized Official

Name: SILKY BAGGA
Title or Position: OWNER/PRACTITIONER
Credential: M.D.
Phone: 804-571-5000