Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 0101-031037 | VA |
Y | 208600000X | Surgeon | 0101-031037 | VA |
NPI | 1013981810 |
---|---|
Provider Name | Kirshan K Tayal |
First Address | Radford, VA 24141-4210 |
Second Address | Roanoke, VA 24014-1838 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2006 |
Last Update Date | 28/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7309864 | (05) | VA |
B06549 | (02) | VA |