Provider Demographics
NPI:1740474527
Name:JASTAN, RASMIYAH MAJDY (MD)
Entity type:Individual
Prefix:
First Name:RASMIYAH
Middle Name:MAJDY
Last Name:JASTAN
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 1:613 CAMPUS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-9703
Mailing Address - Country:US
Mailing Address - Phone:276-628-1186
Mailing Address - Fax:276-628-8507
Practice Address - Street 1:613 CAMPUS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210
Practice Address - Country:US
Practice Address - Phone:276-628-1186
Practice Address - Fax:276-628-8507
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46373207Q00000X
VA0101251591207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1520781Medicaid
P00735774OtherRAILROAD MEDICARE
VA1740474527Medicaid
431560263OtherTRICARE WEST
VAVV9153DMedicare PIN
TN1520781Medicaid
VAVV9153CMedicare PIN
VA1740474527Medicaid