Individual
DR. EKTA BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101254917
VA
207RI0200X
Infectious Disease Physician
Primary
0101254917
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT191999
STATE LICENSE
PA
Enumeration date
08/31/2009
Last updated
09/05/2025
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