Provider Demographics
NPI:1417950023
Name:ASHMAN, CAROL J (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:J
Last Name:ASHMAN
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 1:4668 PEMBROKE BLVD
Mailing Address - Street 2:STE 117
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455
Mailing Address - Country:US
Mailing Address - Phone:757-965-4145
Mailing Address - Fax:757-965-4168
Practice Address - Street 1:4668 PEMBROKE BLVD
Practice Address - Street 2:STE 117
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6423
Practice Address - Country:US
Practice Address - Phone:757-965-4145
Practice Address - Fax:757-965-4168
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350686422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2044157Medicaid
VA015053F78Medicare PIN
VA015115C13Medicare PIN
VA015054R97Medicare PIN
OH2044157Medicaid