Provider Demographics
NPI:1124084041
Name:NASHED, TRISHA BANSAL (MD)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:BANSAL
Last Name:NASHED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2896
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:1880 AMHERST ST
Practice Address - Street 2:SUITE 100 AND SUITE 200
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2873
Practice Address - Country:US
Practice Address - Phone:540-662-0306
Practice Address - Fax:855-264-2066
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21252207R00000X
VA0101058035207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV000875693OtherBLUE SHIELD GROUP #
WV3810003817OtherWV MEDICAID GROUP
2119646OtherMAMSI PROFESSIONAL
WV3003798000Medicaid
MD550941601OtherMD MEDICAID GRP-WV
65465OtherSENTARA PROFESSIONAL
MD304023200Medicaid
MD550941600OtherMD MEDICAID GRP-VA
P00656344OtherRAILROAD MEDICARE
WV001717445OtherBLUE SHIELD
VA010007411Medicaid
WV9371521OtherWV MEDICARE GRP-NEW
289027OtherANTHEM PROFESSIONAL
VA010007411Medicaid
WVC00085Medicare ID - Type UnspecifiedPART B GROUP #
WV3003798000Medicaid
MD550941601OtherMD MEDICAID GRP-WV
MD304023200Medicaid