Provider Demographics
NPI:1871536706
Name:DAVE, ASHESH SHIVPRASAD (MD)
Entity type:Individual
Prefix:DR
First Name:ASHESH
Middle Name:SHIVPRASAD
Last Name:DAVE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 FOX RUN TER
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2809
Mailing Address - Country:US
Mailing Address - Phone:215-343-4821
Mailing Address - Fax:
Practice Address - Street 1:1826 FOX RUN TER
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2809
Practice Address - Country:US
Practice Address - Phone:267-935-4615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD073862L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2010570000OtherKEYSTONE HEALTH PLAN
PA30005580OtherKEYSTONE MERCY HEALTH
PA4847955OtherCIGNA
PA0018643830002Medicaid
PA16077OtherHEALTH PARTNERS
PA7579265OtherAETNA USHC
PA7579265OtherAETNA USHC
PA048396Medicare ID - Type Unspecified