Provider Demographics
NPI:1023020195
Name:SHASHI AYER MD PC
Entity Type:Organization
Organization Name:SHASHI AYER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHASHI
Authorized Official - Middle Name:B
Authorized Official - Last Name:AYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACP, FASN
Authorized Official - Phone:434-392-7615
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-0245
Mailing Address - Country:US
Mailing Address - Phone:434-392-7615
Mailing Address - Fax:434-392-7616
Practice Address - Street 1:1801 E 3RD ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-2905
Practice Address - Country:US
Practice Address - Phone:434-392-7615
Practice Address - Fax:434-392-7616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101047258207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6031412Medicaid
VA0000000096744OtherANTHEM HEALTH
VA6031412Medicaid