Provider Demographics
NPI:1528215811
Name:VYAS, ASHISH ATULBHAI (MD)
Entity Type:Individual
Prefix:
First Name:ASHISH
Middle Name:ATULBHAI
Last Name:VYAS
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 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-747-4159
Mailing Address - Fax:
Practice Address - Street 1:2065 E SOUTH BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2458
Practice Address - Country:US
Practice Address - Phone:334-747-7250
Practice Address - Fax:334-747-7270
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL327342084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL174886Medicaid
AL101I133691OtherMEDICARE
AL174886Medicaid