Individual
NYAZ ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3708 S MAIN ST STE B, BLACKSBURG, VA 24060-7007
(540) 739-3623
(540) 739-3979
Mailing address
PO BOX 8310, ROANOKE, VA 24014-0310
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101272976
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Enumeration date
03/28/2018
Last updated
11/23/2021
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