Provider Demographics
NPI:1184609992
Name:PASLEY, FAITH R (MD)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:R
Last Name:PASLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4705
Mailing Address - Country:US
Mailing Address - Phone:540-982-2957
Mailing Address - Fax:540-981-0954
Practice Address - Street 1:1231 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4705
Practice Address - Country:US
Practice Address - Phone:540-982-2957
Practice Address - Fax:540-981-0954
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101024730207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00368702OtherMEDICARE RAILROAD
B08669Medicare UPIN
012224L84Medicare PIN