Provider Demographics
NPI:1093795775
Name:AFZAL, ASMA (MD)
Entity Type:Individual
Prefix:
First Name:ASMA
Middle Name:
Last Name:AFZAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1803
Mailing Address - Country:US
Mailing Address - Phone:434-791-3630
Mailing Address - Fax:434-791-4088
Practice Address - Street 1:287 COMMONWEALTH BLVD W
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1820
Practice Address - Country:US
Practice Address - Phone:276-632-2966
Practice Address - Fax:276-632-0841
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101229162207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
491862OtherMEDICARE NGS
491863OtherMEDICARE NGS
491862OtherMEDICARE NGS
H35317Medicare UPIN