Individual
DR. ASHISH GAJANAN SHANBHAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14605 POTOMAC BRANCH DR STE 100, WOODBRIDGE, VA 22191
(703) 738-4371
Mailing address
PO BOX 6012, SPARTANBURG, SC 29304-6012
(864) 278-6006
(864) 278-6007
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
19477
SC
208100000X
Physical Medicine & Rehabilitation Physician
19477
SC
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
19477
SC
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
19477
SC
208VP0014X
Interventional Pain Medicine Physician
Primary
0101252651
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194774
—
SC
05
—
722-522
—
SC
Enumeration date
01/06/2007
Last updated
07/23/2018
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