Provider Demographics
NPI:1235190893
Name:KASHYAP, PALLAVI SHAH (DO)
Entity Type:Individual
Prefix:
First Name:PALLAVI
Middle Name:SHAH
Last Name:KASHYAP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:PALLAVI
Other - Middle Name:J
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1256
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20168-8256
Mailing Address - Country:US
Mailing Address - Phone:703-754-4900
Mailing Address - Fax:571-261-5235
Practice Address - Street 1:14535 JOHN MARSHALL HWY
Practice Address - Street 2:SUITE 105
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-4023
Practice Address - Country:US
Practice Address - Phone:703-754-4900
Practice Address - Fax:571-261-5235
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102201486207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine