Provider Demographics
NPI:1497778781
Name:NASH, HOWARD ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:ROBERT
Last Name:NASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SOUTH ST.
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-1199
Mailing Address - Country:US
Mailing Address - Phone:434-392-3984
Mailing Address - Fax:434-392-1038
Practice Address - Street 1:111 SOUTH ST.
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901
Practice Address - Country:US
Practice Address - Phone:434-392-3984
Practice Address - Fax:434-392-1038
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010328812083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6699260Medicaid
VA6699260Medicaid