Individual
ANIL LORROL GANGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 915-0010
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
363A00000X
Physician Assistant
0110002654
VA
363AM0700X
Medical Physician Assistant
0110002654
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194904375
—
VA
Enumeration date
10/24/2007
Last updated
04/15/2024
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