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General NPI Number Information
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NPI Number | 1982895462
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Entity Type | Organization
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Legal Business Name | DANVILLE NEUROLOGY & SLEEP CENTER
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 08/08/2007
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Provider Practice Location Address
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Address Line | 130 GRAY ST
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City | DANVILLE
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State | VA
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Zip | 24541-2942
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Country | US
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Telephone | 434-792-3131
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Fax | 434-792-3303
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Provider Business Mailing Address
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Address Line | 130 GRAY ST
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City | DANVILLE
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State | VA
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Zip | 24541-2942
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Country | US
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Telephone | 434-792-3131
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Fax | 434-792-3303
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Authorized Official
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Title or Position | M.D.
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Name | DR. MUGABALA B ASWATH
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Credential | M.D
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Telephone | 434-792-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101058334
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License Number State | VA
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