Provider Demographics
NPI:1609156801
Name:VAISHNAV, SAKSHI (MD)
Entity Type:Individual
Prefix:
First Name:SAKSHI
Middle Name:
Last Name:VAISHNAV
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 1:415 MORRIS ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1840
Mailing Address - Country:US
Mailing Address - Phone:304-388-7821
Mailing Address - Fax:304-388-7820
Practice Address - Street 1:415 MORRIS ST STE 100
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1840
Practice Address - Country:US
Practice Address - Phone:269-568-8868
Practice Address - Fax:304-388-7820
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301098142207R00000X, 390200000X
IN01076456A207R00000X
WV30819207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
ININ2762118Medicare PIN