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General NPI Number Information
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NPI Number | 1215273206
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Entity Type | Organization
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Legal Business Name | EMILY ASHLEY
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Dates
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Enumeration Date | 12/19/2012
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 3335 S CRATER RD
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City | PETERSBURG
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State | VA
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Zip | 23805-9214
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Country | US
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Telephone | 804-765-5445
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Fax |
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Provider Business Mailing Address
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Address Line | 104 SEVEN PINES AVE
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City | SANDSTON
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State | VA
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Zip | 23150-1600
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Country | US
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Telephone | 804-439-3859
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. SILKY BAGGA
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Credential | M.D.
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Telephone | 804-439-3859
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101246465
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License Number State | VA
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