Individual
DR. AYESHA NAZLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3716 MELROSE AVE NW, ROANOKE, VA 24017-2716
(540) 362-0360
(540) 362-5590
Mailing address
3716 MELROSE AVE NW, ROANOKE, VA 24017-2716
(540) 362-0360
(540) 362-5590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101239912
VA
207Q00000X
Family Medicine Physician
22742
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000056944U
HUMANA
WV
01
—
001969694
MOUNTAIN STATE BLUE CROSS
WV
05
—
3810009211
—
WV
01
—
P00401503
RAILROAD MEDICARE PIN
WV
Enumeration date
05/17/2007
Last updated
12/27/2012
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