Namarta Gill

Individual provider Active NPI Physician Assistant · Moneta, VA

NPI 1508436767 · NPPES record last updated Nov 16, 2022

Key facts

NPI
1508436767
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
0110008111 (VA)
Practice address
4830 Rucker Rd
Moneta, VA 24121-5281
Phone
(540) 297-7181
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110008111VAMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 0110008111 VA Yes

Addresses

Primary practice location

4830 Rucker Rd
Moneta, VA 24121-5281

Mailing address

4830 Rucker Rd
Moneta, VA 24121-5281

Other providers in Moneta, VA

All providers in Moneta, VA · Physician Assistant in Virginia

Sources for this page

Verify at the official NPI Registry.