Provider Demographics
NPI:1003216714
Name:HAGAMAN, ASHLEIGH LAUREN RAPP (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:LAUREN RAPP
Last Name:HAGAMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHLEIGH
Other - Middle Name:LAUREN
Other - Last Name:RAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8262 ATLEE ROAD
Mailing Address - Street 2:MOB 3, SUITE 205
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116
Mailing Address - Country:US
Mailing Address - Phone:804-559-0194
Mailing Address - Fax:804-417-1427
Practice Address - Street 1:8262 ATLEE ROAD
Practice Address - Street 2:MOB 3, SUITE 205
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116
Practice Address - Country:US
Practice Address - Phone:804-559-0194
Practice Address - Fax:804-417-1427
Is Sole Proprietor?:No
Enumeration Date:2014-08-29
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR9768208600000X
VA0101269664208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1003216714Medicaid