Provider Demographics
NPI:1538138680
Name:ASHRAF, MOHAMMED KHAIRUL (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:KHAIRUL
Last Name:ASHRAF
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 1:2091 LANGHORNE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1428
Mailing Address - Country:US
Mailing Address - Phone:434-851-2688
Mailing Address - Fax:434-455-5947
Practice Address - Street 1:2091 LANGHORNE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1428
Practice Address - Country:US
Practice Address - Phone:434-947-3954
Practice Address - Fax:434-455-5947
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230258207RN0300X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA217404OtherTRIGON
VA5857376Medicaid
VA390000188Medicare ID - Type Unspecified
VA5857376Medicaid