Provider Demographics
NPI:1902034150
Name:O'REILLY, ASHLEY G (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:G
Last Name:O'REILLY
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 1:6231 LEESBURG PIKE STE 500
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2102
Mailing Address - Country:US
Mailing Address - Phone:703-644-7800
Mailing Address - Fax:
Practice Address - Street 1:6231 LEESBURG PIKE STE 500
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2102
Practice Address - Country:US
Practice Address - Phone:703-536-2729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MN53123207Y00000X
VA0101256004207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP01021811OtherRAILROAD MEDICARE
VA040000998Medicare PIN
MNP01021811OtherRAILROAD MEDICARE