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General NPI Number Information
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NPI Number | 1427411594
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Entity Type | Individual
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Provider Name | HAVYA ANKLESHKUMAR DAVE M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/05/2016
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 2280 OPITZ BLVD STE 250
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3362
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Country | US
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Telephone | 703-523-1720
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Fax |
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Provider Business Mailing Address
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Address Line | 208 MEDICAL PARK BLVD
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City | BRISTOL
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State | TN
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Zip | 37620-7343
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0101267015
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License Number State | VA
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