Healthcare Provider Details

I. General information

NPI: 1255741484
Provider Name (Legal Business Name): LINDSAY A REGALI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 07/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 BERNARD DR STE 201
ROANOKE VA
24018
US

IV. Provider business mailing address

PO BOX 13306
ROANOKE VA
24032-3306
US

V. Phone/Fax

Practice location:
  • Phone: 540-345-0289
  • Fax: 540-345-9569
Mailing address:
  • Phone: 540-345-0289
  • Fax: 540-345-9569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101264762
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: