| Emily Ashley | |
|
3335 S Crater Rd Petersburg VA 23805-9214 | |
| (804) 765-5445 | |
| Not Available |
| Full Name | Emily Ashley |
|---|---|
| Speciality | Family Medicine |
| Location | 3335 S Crater Rd, Petersburg, Virginia |
| Authorized Official Name and Position | Silky Bagga (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8044393859 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emily Ashley 104 Seven Pines Ave Sandston VA 23150-1600 Ph: (804) 439-3859 | Emily Ashley 3335 S Crater Rd Petersburg VA 23805-9214 Ph: (804) 765-5445 |
| NPI Number | 1215273206 |
|---|---|
| Provider Enumeration Date | 12/19/2012 |
| Last Update Date | 10/27/2014 |
| Medicare PECOS PAC ID | 5991950685 |
|---|---|
| Medicare Enrollment ID | O20130304000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215273206 | NPI | - | NPPES |
| 1215273206 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101246465 (Virginia) | Primary |
| Provider Name | Silky K Bagga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467788406 PECOS PAC ID: 1658411418 Enrollment ID: I20091229000631 |
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