Basic Information
| Provider Information | |||||||||
| NPI: | 1598950644 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VASHIST | ||||||||
| FirstName: | AMIT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16000 JOHNSTON MEMORIAL DR | ||||||||
| Address2: | FOURTH FLOOR | ||||||||
| City: | ABINGDON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242117659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2762584050 | ||||||||
| FaxNumber: | 2762584056 | ||||||||
| Practice Location | |||||||||
| Address1: | 16000 JOHNSTON MEMORIAL DR | ||||||||
| Address2: | FOURTH FLOOR | ||||||||
| City: | ABINGDON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242117659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2762584050 | ||||||||
| FaxNumber: | 2762584056 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2007 | ||||||||
| LastUpdateDate: | 02/27/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 47570 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 47570 | TN | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 0101251218 | VA | N | Allopathic & Osteopathic Physicians | Hospitalist | 2084P0800X | 47570 | TN | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | 0101251218 | VA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 207R00000X | 0101251218 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1598950644 | 05 | VA | MEDICAID | 1530358 | 05 | TN | MEDICAID | P01285058 | 01 | VA | RAILROAD MEDICARE | OTHER | P01675463 | 01 | TN | RAILROAD MEDICARE | OTHER | 1598950644 | 05 | NC | MEDICAID |