Provider Demographics
NPI:1265411573
Name:NOBBEE, VASHIST (MD)
Entity type:Individual
Prefix:DR
First Name:VASHIST
Middle Name:
Last Name:NOBBEE
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 1:1802 ELECTRIC RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-1619
Mailing Address - Country:US
Mailing Address - Phone:540-283-3760
Mailing Address - Fax:540-989-2869
Practice Address - Street 1:1802 ELECTRIC RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1619
Practice Address - Country:US
Practice Address - Phone:540-283-3760
Practice Address - Fax:540-989-2869
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101227459207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00277035OtherMEDICARE RAILROAD
VA005857619Medicaid
H36207Medicare UPIN
VA00W746L72Medicare PIN