Provider Demographics
NPI:1255300505
Name:DAVE, AKSHAY S (MD)
Entity Type:Individual
Prefix:
First Name:AKSHAY
Middle Name:S
Last Name:DAVE
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:325 CHARLES H DIMMOCK PKWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-2986
Mailing Address - Country:US
Mailing Address - Phone:804-524-0060
Mailing Address - Fax:804-524-0064
Practice Address - Street 1:325 CHARLES H DIMMOCK PKWY
Practice Address - Street 2:SUITE 500
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2986
Practice Address - Country:US
Practice Address - Phone:804-524-0060
Practice Address - Fax:804-524-0064
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2022-06-21
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101054531207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006096051Medicaid
VA110006546Medicare PIN
G43780Medicare UPIN