Healthcare Provider Details

I. General information

NPI: 1952890071
Provider Name (Legal Business Name): NIRAJAN ADHIKARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2018
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date: 12/13/2018
Reactivation Date: 02/04/2019

III. Provider practice location address

2001 CRYSTAL SPRING AVE SW STE 300
ROANOKE VA
24014-2465
US

IV. Provider business mailing address

213 S JEFFERSON ST STE 1006
ROANOKE VA
24011-1713
US

V. Phone/Fax

Practice location:
  • Phone: 540-985-8505
  • Fax: 540-344-3313
Mailing address:
  • Phone: 540-224-5516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101277948
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD474902
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: