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General NPI Number Information
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NPI Number | 1598225484
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Entity Type | Individual
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Provider Name | VIRA IHORIVNA AYZENBART MD
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Gender | Female
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 1901 TATE SPRINGS RD
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City | LYNCHBURG
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State | VA
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Zip | 24501-1109
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Country | US
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Telephone | 434-200-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 3819 SUNBREEZE CIR APT 321
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City | ROANOKE
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State | VA
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Zip | 24018-3170
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Country | US
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Telephone | 919-621-1694
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0101275394
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License Number State | VA
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